Predicting infection in hospitalized patients with systemic lupus erythematosus

Intern Med. 1996 Aug;35(8):629-36. doi: 10.2169/internalmedicine.35.629.

Abstract

To identify the risk factors for infection and to develop a model for the prediction of infection in hospitalized patients with active systemic lupus erythematosus (SLE), we carried out a retrospective cohort study with clinical data collected from 121 consecutive patients with active SLE. Seventeen patients had infection within 6 months of beginning steroid therapy for active SLE. Independent multivariate predictors of infection were a decrease in the serum albumin value, an increase in the serum creatinine value, and prednisolone use in a dose of > or = 60 mg/day without methylprednisolone pulse therapy. The error rate of the model by 10-fold cross-validation method was 12%, sensitivity was 65%, specificity was 91%, and positive predictive value was 55%. Four nonsurvivors were correctly discriminated. Use of this model could contribute to earlier diagnosis of infection and may assist decisions regarding empiric antimicrobial administration in patients with SLE.

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Creatinine / blood
  • Female
  • Humans
  • Infections / blood
  • Infections / diagnosis
  • Infections / etiology*
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / drug therapy
  • Male
  • Models, Biological
  • Models, Statistical
  • Prednisolone / administration & dosage
  • Prednisolone / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin / metabolism

Substances

  • Serum Albumin
  • Prednisolone
  • Creatinine