Screening tool development for hand surgery referrals in systemic sclerosis

被引:0
|
作者
de Abreu, Marcos Felipe Marcatto [1 ]
Landin, Sibila [2 ]
Yuamoto, Fernanda Yuri [1 ]
Lins, Carolina [1 ]
Magalhaes, Eduardo Paiva [1 ]
Etchebehere, Mauricio [1 ]
机构
[1] Univ Estadual Campinas UNICAMP, Fac Ciencias Med, Dept Orthoped Rheumatol & Traumatol, Campinas, SP, Brazil
[2] Catholic Univ Temuco, Dept Therapeut Proc, Temuco, Araucania, Chile
关键词
Scleroderma systemic; Orthopedic procedures; Cross-sectional studies; Skin ulcer; Referral and consultation; ASSESSMENT QUESTIONNAIRE HAQ; CLINICAL-TRIALS; SCLERODERMA; SCALE; PREVALENCE; MANAGEMENT; PAIN; REPRODUCIBILITY; MANIFESTATIONS; CLASSIFICATION;
D O I
10.1016/j.clinsp.2023.100270
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Systemic Sclerosis (SSc) patients may need hand surgery. Objective: To develop a screening tool for rheumatologists to identify potential candidates with systemic sclerosis for hand surgery, optimizing referrals.Methods: A pilot cross-sectional study from January 2015 to December 2016. Sample size: 51 participants. Inclusion criteria: = 18 years old, meeting the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for SSc and hand impairment. Data collected: age, sex, race, disease duration, SSc subtypes, vasodilator use, skin thickness, finger stiffness, presence of Digital Ulcers (DU) and/ or calcinosis, presence of Raynaud's Phenomenon (RP) attacks, health status and disability, disease status, pain intensity and functional status of the hands. Data were analyzed by a multivariate logistic regression model.Results: Fulfillment of surgical criteria: 68.8%. The surgical group had higher scores on the HAQ-DI (1.39 vs. 0.96, p = 0.032) and CHFS (25.0 vs. 12.0, p = 0.005) questionnaires, and a higher frequency of DU (91.43% vs. 18.75%, p < 0.0010), calcinosis (60.0% vs. 0.0%, p < 0.001), use of vasodilators (100.0% vs. 75.0%, p = 0.007) and digital stiffness (28.57% vs. 0.0%, p = 0.017). The presence of DU increased the chance of surgical indication by 46.2 times (ORIC 95% = 8.23 to 259.49). The statistical model showed good accuracy (86.3%, p < 0.001), sensitivity (91.4%), and specificity (81.2%).Conclusion: The presence of DU in SSc could be used as a screening feature for early identification and referral of potential candidates for hand surgery.
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页数:5
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