Pretreatment mortality risk prediction model in patients with polymyositis/dermatomyositis-associated interstitial lung disease

作者：Xianhua Gui, Wang‐Zhong Li, Hanyi Jiang, Rujia Wang, Min Yu, Tingting Zhao, Miao Ma, Jingjing Ding, Ziyi Jin, Yuying Qiu, Xiaohua Qiu, Yingwei Zhang, Min Cao, Mei Huang, Mengshu Cao, Jinghong Dai, Hourong Cai, Xiaoyan Xin, Yonglong Xiao · 发表于：RMD Open · 年份：2024 · DOI：10.1136/rmdopen-2023-003850 · 被引用次数：8 · 研究领域：Inflammatory Myopathies and Dermatomyositis、Systemic Sclerosis and Related Diseases、Parkinson's Disease and Spinal Disorders

OBJECTIVES: Risk prediction for patients with polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD) is challenging due to heterogeneity in the disease course. We aimed to develop a mortality risk prediction model for PM/DM-ILD. METHODS: This prognostic study analysed patients with PM/DM-ILD admitted to Nanjing Drum Hospital from 2016 to 2021. The primary outcome was mortality within 1 year. We used a least absolute shrinkage and selection operator (LASSO) logistic regression model to identify predictive laboratory indicators. These indicators were used to create a laboratory risk score, and we developed a mortality risk prediction model by incorporating clinical factors. The evaluation of model performance encompassed discrimination, calibration, clinical utility and practical application for risk prediction and prognosis. RESULTS: Overall, 418 patients with PM/DM-ILD were enrolled and randomly divided into development (n=282) and validation (n=136) cohorts. LASSO logistic regression identified four optimal features in the development cohort, forming a laboratory risk score: C reactive protein, lactate dehydrogenase, CD3+CD4+ T cell counts and PO2/FiO2. The final prediction model integrated age, arthralgia, anti-melanoma differentiation-associated gene 5 antibody status, high-resolution CT pattern and the laboratory risk score. The prediction model exhibited robust discrimination (area under the receiver operating characteristic: 0.869, 95% CI 0.811 to...