Domsic et al reported a prediction rule for predicting 5-year mortality rate for a patient with early diffuse cutaneous systemic sclerosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Pittsburgh, University College London, Roayl Free Hospital, Veterans Affairs Pittsburgh Healthcare and University of Arizona.
Patient selection: early diffuse cutaneous systemic sclerosis
Parameters:
(1) age at first visit
(2) sex
(3) tendon friction rubs
(4) gastrointestinal tract involvement
(5) anti-RNAP III antibody
(6) hemoglobin in g/dL (as a measure of anemia)
Parameter
Finding
Points
age in years
< 35 years
-1
35 to 64 years
0
>= 65 years
1
sex
female
0
male
1
tendon friction rubs
0
0
>= 1
1
GI involvement
no
0
yes
1
anti-RNAP III antibody
negative
0
positive
-1
hemoglobin
>= 12 g/dL
0
< 12 g/dL
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -2
• maximum score: 5
Total Score
Risk Group
5-Year Mortality Rate
-2 to 0
low
6-8%
1 or 2
moderate
29-33%
3 to 5
high
50-64%
Performance:
• The area under the ROC curve was 0.73 for a Pittsburgh cohort and 0.69 for a Royal Free Hospital cohort.
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