Predicting infection in hospitalized patients with systemic lupus erythematosus.
To identify the risk factors for infection and to develop a model for the prediction of infection in hospitalized patients with active systemic lupus erythematosus (SLE), we carried out a retrospective cohort study with clinical data collected from 121 consecutive patients with active SLE. Seventeen patients had infection within 6 months of beginning steroid therapy for active SLE. Independent multivariate predictors of infection were a decrease in the serum albumin value, an increase in the serum creatinine value, and prednisolone use in a dose of > or = 60 mg/day without methylprednisolone pulse therapy. The error rate of the model by 10-fold cross-validation method was 12%, sensitivity was 65%, specificity was 91%, and positive predictive value was 55%. Four nonsurvivors were correctly discriminated. Use of this model could contribute to earlier diagnosis of infection and may assist decisions regarding empiric antimicrobial administration in patients with SLE.
Yuhara
T
T
Department of Internal Medicine, University of Tsukuba.
Takemura
H
H
Akama
T
T
Suzuki
H
H
Yamane
K
K
Kashiwagi
H
H
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007239:Infections / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008954:Models, Biological; D015233:Models, Statistical; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism
D012709:Serum Albumin; D011239:Prednisolone; D003404:Creatinine