Legge et al identified factors associated with organ damage progression in a patient with systemic lupus erythematosus (SLE). These can help to identify a patient who may benefit from more aggressive management. The authors are from Dalhousie University and the Nova Scotia Health Authority.
Patient selection: SLE
Outcome: increase in SLICC/ACR damage index
Risk factors for progression of organ damage:
(1) age of the patient (mean age was 44 years of age with standard deviation 14.6)
(2) SLICC/ACR damage index at baseline (indicates pre-existing damage)
(3) number of ACR classificaton criteria
(4) therapy with immunosuppressive drugs
(5) cigarette smoking
(6) high mean C-reactive protein
Parameter
Finding
Points
age of the patient
younger
0
older
1
SLICC/ACR damage index at baseline
0
0
>= 1
1
ACR classification criteria
< 8
0
>= 8
1
immunosuppressive drugs
no
0
yes
1
cigarette smoking
no
0
yes (current or past)
1
C-reactive protein
low
0
high
1
total number of predictors =
= SUM(points for all 6 risk factors)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk for progression in organ damage.
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