Construction and validation of a risk warning model for infection in patients with systemic lupus erythematosus during immunosuppressive therapy
YIN Juan
SUN Su
Abstract：Objective:To explore the risk factors for infection during immunosuppressive therapy in patients with systemic lupus erythematosus(SLE),and to construct and validate the risk prediction model.Methods:The relevant data of 127 SLE patients who received immunosuppressive therapy admitted to the hospital from January 2022 to January 2023 were retrospectively analyzed.They were divided into modeling set(n=89)and validation set(n=38)according to 7∶3,and divided into infected group and non-infected group according to whether infection occurred during treatment.Data of SLE patients were collected.Univariate analysis and multivariate Logistic regression analysis were used to screen for independent influencing factors of infection during immunosuppressive therapy.R software was used to draw a nomogram and calibration diagram to visualize the model and evaluate consistency;ROC was used to evaluate the predictive value of risk prediction model;H-L test was used to judge the goodness of fit of the model.Results:24 of 89 patients in the modeling set developed infection(infection group,n=24;In the uninfected group,n=65),the infection rate was 26.97％.Further multivariate analysis suggested that the course of disease,SLED AI,type of immunosuppressant and age were independent factors for infection during immunosuppressive therapy in SLE patients(P＜0.05).The risk prediction model was as follows:Logit(P)=14.928-0.193 ×(age)-1.265X(course of disease)-1.761 X(type of immunosuppressant used)-0.273×(SLEDAI score).The AUC in the ROC of the modeling set was 0.913(95％CI:0.847,0.979),the sensitivity was 87.5％,and the specificity was 87.7％.In the calibration diagram of the predictive model of the modeling set,the calibration curve was close to the standard curve,indicating that the model had good consistency.H-L goodness of fit test results showed that(x2=8.791,P=0.360;The external validation AUC was 0.916(95％CI:0.848,0.984),the sensitivity was 87.5％,and the specificity was 90.8％.Conclusions:Age,course of disease,SLEDAI score and type of immunosuppressant use are all independent influencing factors for infection during immunosuppressive therapy in SLE patients,and the risk prediction model constructed by this method has good clinical predictive value.
Keywords：systemic lupus erythematosusimmunosuppressioninfectionprediction modelinfluencing factor
Publication Date：2024-12-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 4370-4374 )