Ward et al developed a model for predicting short term mortality for hospitalized patients with systemic lupus erythematosus (SLE. This can help identify patients who may benefit from more aggressive management. The authors are from the National Institutes of Health at the National Institute of Arthritis and Musculoskeletal and Skin Diseases).
Patient selection: hospitalized patient with SLE
Parameters used in a single classification tree:
(1) age in years
(2) SLE Comorbidity Index (SLE CI, see Chapter 1)
(3) Charlson Comorbidity Index (CCI)
(4) respiratory failure
|
SLE CI |
CCI |
Resp Failure |
Age |
Node |
|
< 3.5 |
|
N |
< 54.5 |
A |
|
< 3.5 |
0 |
N |
>= 54.5 |
B |
|
< 3.5 |
> 0 |
N |
>= 54.5 |
C |
|
< 3.5 |
|
Y |
|
D |
|
>= 3.5 |
< 2.5 |
N |
< 32.5 |
E |
|
>= 3.5 |
0 |
N |
>= 32.5 |
F |
|
>= 3.5 |
> 0 and < 2.5 |
N |
>= 32.5 |
G |
|
>= 3.5 |
< 2.5 |
Y |
|
H |
|
>= 3.5 |
>= 2.5 |
NA |
|
I |
|
Node |
In Hospital Mortality |
|
A |
0.6% |
|
B |
0% |
|
C |
3.1% |
|
D |
37.5% |
|
E |
0.8% |
|
F |
0% |
|
G |
3.7% |
|
H |
29.2% |
|
I |
16.1% |
where:
• Respiratory failure and high comorbidity define the high risk groups.
Purpose: To evaluate a patient with systemic lupus erythematosus (SLE) who has been hospitalized using the model of Ward et al.
Specialty: Immunology/Rheumatology
Objective: risk factors, clinical diagnosis, including family history for genetics, imaging studies, laboratory tests, complication detection, prevention
ICD-10: M32.0, M32.1, M32.8, M32.9,
