Elsevier

EClinicalMedicine

Volume 36, June 2021, 100900
EClinicalMedicine

Research paper
A nomogram to predict the risk of lupus enteritis in systemic lupus erythematosus patients with gastroinctestinal involvement

https://doi.org/10.1016/j.eclinm.2021.100900Get rights and content
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Abstract

Background

Lupus enteritis (LE), a main cause of acute abdominal pain in systemic lupus erythematosus (SLE) patients, is a serious and potentially fatal complication. This study aimed to identify clinical serological indicators to establish a nomogram to assess LE in SLE patients with gastrointestinal manifestations.

Methods

The clinical and laboratory data of SLE patients with gastrointestinal manifestations that were hospitalized in the West China Hospital from January 2010 to January 2020 were retrospectively analyzed. The least absolute shrinkage and selection operator logistic regression model was used to select potentially relevant features. Subsequently, a nomogram was developed using multivariable logistic analysis. The performance of the nomogram was evaluated using a receiver operating characteristic curve, a calibration curve, and decision curve analysis (DCA).

Findings

We included a total of 8,505 SLE patients, of which 251 had experienced gastrointestinal manifestations. The patients were randomly divided into training (n = 176) and validation (n = 75) groups. The LRA (LE Risk Assessment) model consisted of 11 significantly associated variables, which included complement 4, antineutrophil cytoplasmic antibody, albumin, anion gap, age, d-dimer, platelet, serum chlorine, anti-Sjögren's-syndrome-related antigen A, anti-ribosomal P protein, and anti-ribonucleoprotein. In the training and validation cohorts, the areas under the curve were 0.919 (95% confidence interval [CI]: 0.876–0.962) and 0.870 (95% CI: 0.775–0.964), respectively. The nomogram demonstrated excellent performance in the calibration curve and DCA.

Interpretation

The LRA model exhibits good predictive ability in assessing LE risk in SLE patients with gastrointestinal manifestations.

Funding

This work was supported by the National Key Research and Development Program of China (Project no. 2016YFC0906201) and by the 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (Project No. ZYGD18015).

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These authors have contributed equally to this work