Derivation of Sa-MoDEI score from DEI. Tak for prognostication in Buerger's Disease - Preliminary data of a prospective observational cohort
Background: Buerger's disease or thromboangitis obliterans (TAO) is a segmental occlusive inflammatory condition of vessels. Assessment of disease activity in TAO is challenging. There is no dedicated prognostication score available till date for Buerger's disease. Hence, our aim was to pr...
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SAGE Publishing
2021-01-01
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| Series: | Indian Journal of Rheumatology |
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| Online Access: | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=4;spage=402;epage=407;aulast=Pathrose |
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| author | Gregory Pathrose Albert A Kota Prabhu Premkumar Prasanna Samuel Shivraj Padiyar Deepak Selvaraj Prasanta Padhan Debashish Danda |
| author_facet | Gregory Pathrose Albert A Kota Prabhu Premkumar Prasanna Samuel Shivraj Padiyar Deepak Selvaraj Prasanta Padhan Debashish Danda |
| author_sort | Gregory Pathrose |
| collection | DOAJ |
| description | Background: Buerger's disease or thromboangitis obliterans (TAO) is a segmental occlusive inflammatory condition of vessels. Assessment of disease activity in TAO is challenging. There is no dedicated prognostication score available till date for Buerger's disease. Hence, our aim was to prognosticate outcomes in patients with diagnosed Buerger's disease using Sa-MoDEI score, a novel disease extent index (DEI) derived and modified from DEI. Tak score used in Takayasu's arteritis.
Patients and Methods: In this prospective observational study, patients with TAO presenting to the Department of Vascular Surgery from June 2007 to April 2009 were studied. Shinoya's criteria were used to diagnose patients with Buerger's disease. Patients were scored on the basis of vascular, laboratory, and other clinical presentations as detailed in the Sa-MoDEI pro forma. They were followed up for 12 months after baseline scoring. Amputation was considered a bad outcome. The receiver operating characteristic curve was used to delineate a specific cut-off Sa-MODEI score to define bad outcomes. Factors associated with bad outcomes were analyzed using Cox proportional hazards model.
Results: There were 84 patients with Buerger's disease. All were male with a significant history of tobacco use (smoking cigarettes or “beedis” [leaf cigarettes used in south Asian nations especially in countryside], chewing tobacco, and inhaling snuff). The mean age was 39 years (standard deviation [S. D] ± 6.8). Duration of smoking was 15.35 years (S.D ± 6.2); 65 patients were in good outcome and 19 patients in bad outcome group. The optimal Sa-MoDEI score cut-off for the bad outcome was 8 which corresponded with Youden's Index. Independent factors associated with bad outcome on multivariate analysis were age of onset below 39 years (Hazard Ratio [HR] = 6.00, 95% confidence interval [CI] (1.35–26.67), P = 0.019) and Sa-MoDEI score above 8 (HR = 9.77, 95% CI (2.60–36.71), P = 0.001).
Conclusions: Sa-MoDEI score can be used as a tool to predict limb salvage in Buerger's disease. |
| format | Article |
| id | doaj-art-8586d6d4f1384be7a5245e08315ef62a |
| institution | Kabale University |
| issn | 0973-3698 0973-3701 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | SAGE Publishing |
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| series | Indian Journal of Rheumatology |
| spelling | doaj-art-8586d6d4f1384be7a5245e08315ef62a2025-02-03T12:03:21ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012021-01-0116440240710.4103/injr.injr_90_21Derivation of Sa-MoDEI score from DEI. Tak for prognostication in Buerger's Disease - Preliminary data of a prospective observational cohortGregory PathroseAlbert A KotaPrabhu PremkumarPrasanna SamuelShivraj PadiyarDeepak SelvarajPrasanta PadhanDebashish DandaBackground: Buerger's disease or thromboangitis obliterans (TAO) is a segmental occlusive inflammatory condition of vessels. Assessment of disease activity in TAO is challenging. There is no dedicated prognostication score available till date for Buerger's disease. Hence, our aim was to prognosticate outcomes in patients with diagnosed Buerger's disease using Sa-MoDEI score, a novel disease extent index (DEI) derived and modified from DEI. Tak score used in Takayasu's arteritis. Patients and Methods: In this prospective observational study, patients with TAO presenting to the Department of Vascular Surgery from June 2007 to April 2009 were studied. Shinoya's criteria were used to diagnose patients with Buerger's disease. Patients were scored on the basis of vascular, laboratory, and other clinical presentations as detailed in the Sa-MoDEI pro forma. They were followed up for 12 months after baseline scoring. Amputation was considered a bad outcome. The receiver operating characteristic curve was used to delineate a specific cut-off Sa-MODEI score to define bad outcomes. Factors associated with bad outcomes were analyzed using Cox proportional hazards model. Results: There were 84 patients with Buerger's disease. All were male with a significant history of tobacco use (smoking cigarettes or “beedis” [leaf cigarettes used in south Asian nations especially in countryside], chewing tobacco, and inhaling snuff). The mean age was 39 years (standard deviation [S. D] ± 6.8). Duration of smoking was 15.35 years (S.D ± 6.2); 65 patients were in good outcome and 19 patients in bad outcome group. The optimal Sa-MoDEI score cut-off for the bad outcome was 8 which corresponded with Youden's Index. Independent factors associated with bad outcome on multivariate analysis were age of onset below 39 years (Hazard Ratio [HR] = 6.00, 95% confidence interval [CI] (1.35–26.67), P = 0.019) and Sa-MoDEI score above 8 (HR = 9.77, 95% CI (2.60–36.71), P = 0.001). Conclusions: Sa-MoDEI score can be used as a tool to predict limb salvage in Buerger's disease.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=4;spage=402;epage=407;aulast=Pathrosebuerger's diseasemodified disease extent index score (sa-modei)prognosticationtakayasu's arteritisthromboangitis obliterans |
| spellingShingle | Gregory Pathrose Albert A Kota Prabhu Premkumar Prasanna Samuel Shivraj Padiyar Deepak Selvaraj Prasanta Padhan Debashish Danda Derivation of Sa-MoDEI score from DEI. Tak for prognostication in Buerger's Disease - Preliminary data of a prospective observational cohort Indian Journal of Rheumatology buerger's disease modified disease extent index score (sa-modei) prognostication takayasu's arteritis thromboangitis obliterans |
| title | Derivation of Sa-MoDEI score from DEI. Tak for prognostication in Buerger's Disease - Preliminary data of a prospective observational cohort |
| title_full | Derivation of Sa-MoDEI score from DEI. Tak for prognostication in Buerger's Disease - Preliminary data of a prospective observational cohort |
| title_fullStr | Derivation of Sa-MoDEI score from DEI. Tak for prognostication in Buerger's Disease - Preliminary data of a prospective observational cohort |
| title_full_unstemmed | Derivation of Sa-MoDEI score from DEI. Tak for prognostication in Buerger's Disease - Preliminary data of a prospective observational cohort |
| title_short | Derivation of Sa-MoDEI score from DEI. Tak for prognostication in Buerger's Disease - Preliminary data of a prospective observational cohort |
| title_sort | derivation of sa modei score from dei tak for prognostication in buerger s disease preliminary data of a prospective observational cohort |
| topic | buerger's disease modified disease extent index score (sa-modei) prognostication takayasu's arteritis thromboangitis obliterans |
| url | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=4;spage=402;epage=407;aulast=Pathrose |
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