• Clinics · Jan 2023

    Screening tool development for hand surgery referrals in systemic sclerosis.

    • Marcos Felipe Marcatto de Abreu, Síbila Landim, Fernanda Yuri Yuamoto, Carolina Lins, Eduardo Paiva Magalhães, and Maurício Etchebehere.
    • Department of Orthopedics, Rheumatology and Traumatology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil. Electronic address: marcosmarcatto@hc.unicamp.br.
    • Clinics (Sao Paulo). 2023 Jan 1; 78: 100270100270.

    BackgroundSystemic Sclerosis (SSc) patients may need hand surgery.ObjectiveTo develop a screening tool for rheumatologists to identify potential candidates with systemic sclerosis for hand surgery, optimizing referrals.MethodsA pilot cross-sectional study from January 2015 to December 2016.Sample Size51 participants.Inclusion Criteria≥ 18 years old, meeting the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for SSc and hand impairment.Data Collectedage, sex, race, disease duration, SSc subtypes, vasodilator use, skin thickness, finger stiffness, presence of Digital Ulcers (DU) and/or calcinosis, presence of Raynaud's Phenomenon (RP) attacks, health status and disability, disease status, pain intensity and functional status of the hands. Data were analyzed by a multivariate logistic regression model.ResultsFulfillment of surgical criteria: 68.8%. The surgical group had higher scores on the HAQ-DI (1.39 vs. 0.96, p = 0.032) and CHFS (25.0 vs. 12.0, p = 0.005) questionnaires, and a higher frequency of DU (91.43% vs. 18.75%, p < 0.0010), calcinosis (60.0% vs. 0.0%, p < 0.001), use of vasodilators (100.0% vs. 75.0%, p = 0.007) and digital stiffness (28.57% vs. 0.0%, p = 0.017). The presence of DU increased the chance of surgical indication by 46.2 times (ORIC 95% = 8.23 to 259.49). The statistical model showed good accuracy (86.3%, p < 0.001), sensitivity (91.4%), and specificity (81.2%).ConclusionThe presence of DU in SSc could be used as a screening feature for early identification and referral of potential candidates for hand surgery.Copyright © 2023. Published by Elsevier España, S.L.U.

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