Domsic et al developed a rule for predicting mortality 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, Royal Free Hospital and the VA Pittsburgh Healthcare.
Patient: early diffuse cutaneous systemic sclerosis
Parameters:
(1) age of the patient at the time of the first visit in years
(2) skin thickness progression rate (STPR)
(3) Medsger GI severity
(4) hemoglobin in g/dL (as measure of anemia)
Parameter
Finding
Points
age of the patient
< 45 years
-1
45 to 54 years
0
> 54 years
1
STPR
slow or intermediate
0
rapid
1
Medsger GI severity
none
0
mild or moderate
1
severe or end-stage
2
hemoglobin
>= 12 g/dL
0
< 12 g/dL
2
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: -1
• maximum score: 6
• The higher the score the greater the risk.
Score
Risk
<= 0
low
1 or 2
moderate
3 to 6
high
Performance:
• The area under the ROC curve ranged from 0.62 to 0.65.
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