@article{10902/33029,
year = {2024},
url = {https://hdl.handle.net/10902/33029},
abstract = {Objective: To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort. Methods: We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. A multivariable logistic model was constructed taking into account the variables already forming the SLESIS score, plus all other potential predictors identified in a literature review. Performance was analysed using the C-statistic and the area under the receiver operating characteristic curve (AUROC). Internal validation was carried out using a 100-sample bootstrapping procedure. ORs were transformed into score items, and the AUROC was used to determine performance. Results: A total of 1459 patients who had completed 1 year of follow-up were included in the development cohort (mean age, 49±13 years; 90% women). Twenty-five (1.7%) had experienced ≥1 severe infection. According to the adjusted multivariate model, severe infection could be predicted from four variables: age (years) ≥60, previous SLE-related hospitalisation, previous serious infection and glucocorticoid dose. A score was built from the best model, taking values from 0 to 17. The AUROC was 0.861 (0.777-0.946). The cut-off chosen was ≥6, which exhibited an accuracy of 85.9% and a positive likelihood ratio of 5.48. Conclusions: SLESIS-R is an accurate and feasible instrument for predicting infections in patients with SLE. SLESIS-R could help to make informed decisions on the use of immunosuppressants and the implementation of preventive measures.},
organization = {Funding: The authors declare that financial support for this study was received from the Spanish Foundation of Rheumatology (2021 research grant to the main author). The RELESSER-PROS register received financial support from GSK.
Acknowledgements: We are grateful to the RELESSER group collaborators for their invaluable contributions to register data collection. We also are grateful to the employees of the Spanish Rheumatology Society Research Unit for their commitment and professionalism. Finally, we are also grateful to SER for their review of the English translation of the manuscript.},
publisher = {BMJ Publishing Group},
publisher = {Lupus Science and Medicine, 2024, 11, e001096},
title = {SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort},
author = {Rua-Figueroa, Íñigo and García de Yébenes, M. Jesús and Martínez-Barrio, Julia and Galindo Izquierdo, María and Calvo Alén, Jaime and Fernández-Nebro, Antonio and Menor-Almagro, Raúl and Carmona, Loreto and Tejera Segura, Beagtriz and Tomero, Eva and Freire-González, Mercedes and Sangüesa, Clara and Horcada-Loreto and Blanco Alonso, Ricardo and Uriarte-Itzazelaia, Esther and Narváez, Javier and Rosas Gómez de Salazar, José Carlos and Gómez-Sabater, Silvia and Moriano Moralex, Claudia and Andreu, José L.},
}