Preliminary nomogram model for predicting irreversible organ damage of patients with systemic sclerosis.

IF 4.7 2区医学 Q1 RHEUMATOLOGY

Rheumatology Pub Date : 2025-02-01 DOI:10.1093/rheumatology/keae083

Xiaocong Huo, Xinxiang Huang, Yanting Yang, Chengcheng Wei, Danli Meng, Rongjun Huang, Jinying Lin

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引用次数: 0

Abstract

Objective: To investigate predictive factors for irreversible organ damage in systemic sclerosis (SSc) and establish a nomogram model.

Methods: This retrospective study included patients with SSc who were treated at our hospital between March 2013 and March 2023. Irreversible organ damage included heart failure, respiratory failure, renal failure, and gangrene of the hands and feet. Cox and LASSO regression analyses were performed to determine the predictive factors. Based on the results, a nomogram model was developed. The model was evaluated using the C-indices, calibration plots and DCA.

Results: A total of 361 patients with systemic sclerosis were randomly divided into the development (n = 181) and validation (n = 180) groups. Multivariate Cox regression analysis showed that age ≥65 years, weight loss, digital ulcers, mRSS ≥16, elevated creatinine, elevated myoglobin, elevated C-reactive protein, renal involvement and cardiac involvement were independent risk factors. Based on the LASSO analysis, a nomogram model of irreversible organ damage was established. The C-indices of the development group at 24, 60 and 96 m were 96.7, 84.5 and 85.7, whereas those of the validation group at 24, 60 and 96 m were 86.6, 79.1 and 78.5, respectively. The results of the DCA showed that the nomogram can be used as a valuable tool to predict irreversible organ damage in patients with SSc.

Conclusion: We included commonly used clinical indicators. According to the nomogram, the probability of irreversible organ damage can be calculated and high-risk patients can be identified.

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预测系统性硬化症患者不可逆器官损伤的初步提名图模型。

目的：研究系统性硬化症（SSc）不可逆器官损伤的预测因素并建立提名图模型：研究系统性硬化症（SSc）不可逆器官损伤的预测因素，并建立一个提名图模型：这项回顾性研究纳入了2013年3月至2023年3月期间在我院接受治疗的系统性硬化症患者。不可逆器官损伤包括心力衰竭、呼吸衰竭、肾衰竭和手足坏疽。为了确定预测因素，我们进行了 Cox 和 LASSO 回归分析。根据分析结果，建立了一个提名图模型。使用 C 指数、校准图和 DCA 对模型进行了评估：共有 361 名系统性硬化症患者被随机分为开发组（181 人）和验证组（180 人）。多变量 Cox 回归分析显示，年龄≥65 岁、体重减轻、数字溃疡、mRSS ≥16、肌酐升高、肌红蛋白升高、C 反应蛋白升高、肾脏受累和心脏受累是独立的风险因素。根据 LASSO 分析，建立了不可逆器官损伤的提名图模型。开发组在 24 米、60 米和 96 米时的 C 指数分别为 96.7、84.5 和 85.7，而验证组在 24 米、60 米和 96 米时的 C 指数分别为 86.6、79.1 和 78.5。DCA的结果表明，提名图可作为预测SSc患者不可逆器官损伤的重要工具：结论：我们纳入了常用的临床指标。结论：我们纳入了常用的临床指标，根据提名图可以计算出不可逆器官损伤的概率，并识别出高风险患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

期刊介绍： Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.