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Risk prediction model in rheumatoid arthritis-associated interstitial lung disease

Kim, HC; Lee, JS; Lee, EY; Ha, Y-J; Chae, EJ; Han, M; Cross, G; ... Song, JW; + view all (2020) Risk prediction model in rheumatoid arthritis-associated interstitial lung disease. Respirology , 25 (12) pp. 1257-1264. 10.1111/resp.13848. Green open access

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Abstract

BACKGROUND AND OBJECTIVE: RA-ILD has a variable clinical course, and its prognosis is difficult to predict. Moreover, risk prediction models for prognosis remain undefined. METHODS: The prediction model was developed using retrospective data from 153 patients with RA-ILD and validated in an independent RA-ILD cohort (n = 149). Candidate variables for the prediction models were screened using a multivariate Cox proportional hazard model. C-statistics were calculated to assess and compare the predictive ability of each model. RESULTS: In the derivation cohort, the median follow-up period was 54 months, and 38.6% of the subjects exhibited a UIP pattern on HRCT imaging. In multivariate Cox analysis, old age (≥60 years, HR: 2.063), high fibrosis score (≥20% of the total lung extent, HR: 4.585), a UIP pattern (HR: 1.899) and emphysema (HR: 2.596) on HRCT were significantly poor prognostic factors and included in the final model. The prediction model demonstrated good performance in the prediction of 5-year mortality (C-index: 0.780, P < 0.001); furthermore, patients at risk were divided into three groups with 1-year mortality rates of 0%, 5.1% and 24.1%, respectively. Predicted and observed mortalities at 1, 2 and 3 years were similar in the derivation cohort, and the prediction model was also effective in predicting prognosis of the validation cohort (C-index: 0.638, P < 0.001). CONCLUSION: Our results suggest that a risk prediction model based on HRCT variables could be useful for patients with RA-ILD.

Type: Article
Title: Risk prediction model in rheumatoid arthritis-associated interstitial lung disease
Location: Australia
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/resp.13848
Publisher version: https://doi.org/10.1111/resp.13848
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: diagnostic, imaging, interstitial lung disease, prognosis, rheumatoid arthritis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10099646
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