Prospective evaluation of the capillaroscopic skin ulcer risk index in systemic sclerosis patients in clinical practice: a longitudinal, multicentre study.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_3B4A790361F0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prospective evaluation of the capillaroscopic skin ulcer risk index in systemic sclerosis patients in clinical practice: a longitudinal, multicentre study.
Journal
Arthritis research & therapy
Author(s)
Walker U.A., Jaeger V.K., Bruppacher K.M., Dobrota R., Arlettaz L., Banyai M., Beron J., Chizzolini C., Groechenig E., Mueller R.B., Spertini F., Villiger P.M., Distler O.
ISSN
1478-6362 (Electronic)
ISSN-L
1478-6354
Publication state
Published
Issued date
25/10/2018
Peer-reviewed
Oui
Volume
20
Number
1
Pages
239
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Nailfold capillaroscopy (NC) is an important tool for the diagnosis of systemic sclerosis (SSc). The capillaroscopic skin ulcer risk index (CSURI) was suggested to identify patients at risk of developing digital ulcers (DUs). This study aims to assess the reliability of the CSURI across assessors, the CSURI change during follow-up and the value of the CSURI in predicting new DUs.
This multicentre, longitudinal study included SSc patients with a history of DUs. NC images of all eight fingers were obtained at baseline and follow-up and were separately analysed by two trained assessors.
Sixty-one patients were included (median observation time 1.0 year). In about 40% of patients (assessor 1, n = 24, 39%; assessor 2, n = 26, 43%) no megacapillary was detected in any of the baseline or follow-up images; hence the CSURI could not be calculated. In those 34 patients in whom CSURI scores were available from both assessors (26% male; median age 57 years) the median baseline CSURI was 5.3 according to assessor 1 (IQR 2.6-16.3), increasing to 5.9 (IQR 1.3-12.0) at follow-up. According to assessor 2, the CSURI diminished from 6.4 (IQR 2.4-12.5) to 5.0 (IQR 1.7-10.0). The ability of a CSURI ≥ 2.96 category to predict new DUs was low (for both assessors, positive predictive value 38% and negative predictive value 50%) and the inter-assessor agreements for CSURI categories were fair to moderate.
In this study, around 40% of patients could not be evaluated with the CSURI due to the absence of megacapillaries. Clinical decisions based on the CSURI should be made with caution.
Current Controlled Trials, ISRCTN04371709 . Registered on 18 March 2011.
Keywords
Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Microscopic Angioscopy/methods, Microscopic Angioscopy/standards, Middle Aged, Prospective Studies, Risk Factors, Scleroderma, Systemic/diagnosis, Scleroderma, Systemic/physiopathology, Skin Ulcer/diagnosis, Skin Ulcer/physiopathology, Capillaroscopic skin ulcer risk index, Digital ulcer prediction, Inter-rater reliability, Nailfold capillaroscopy, Systemic sclerosis
Pubmed
Web of science
Open Access
Yes
Create date
09/11/2018 14:58
Last modification date
20/08/2019 13:31
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