Development and initial validation of the vasculitis damage index for the standardized clinical assessment of damage in the systemic vasculitides
Development and initial validation of the vasculitis damage index for the standardized clinical assessment of damage in the systemic vasculitides
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DOI：
10.1002/art.1780400222
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发表时间：
1997-02-01
影响因子：
--
通讯作者：
Adu, D
中科院分区：
文献类型：
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作者：
Exley, AR;Bacon, PA;Adu, D
Objective.目的：建立和验证血管炎损伤指数（Vasculitis Damage Index，VIM），用于系统性血管炎损伤的标准化临床评估。伯明翰血管炎研究小组采用名义小组共识方法，制定了评估所有系统性血管炎损害的指导原则。损伤被定义为由疤痕引起的不可逆变化，共识原则被发展成治疗方案，包括使用指南、损伤项目列表和术语表。对于100例存活的系统性血管炎患者，末次观察时的中位Risk评分为3在韦格纳肉芽肿亚组中，12例死亡者的中位评分高于47例存活者。（非幸存者中位评分7，四分位距5-8，幸存者中位评分4，四分位距2-5; P = 0.003），100例患者的平均评分，从最初表现到末次观察，系统性血管炎的平均评分增加了3（范围1-4; P < 0.001），与其他损伤指标相比，损伤指数评估项目多，变化敏感（P < 0.001），使用该量表，经过训练的观察者可以产生中等一致的损伤评分。该方法是一种灵敏、可重复、全面和可靠的临床工具，用于量化损伤。本文提供的数据应能够进一步验证和测试特定血管炎综合征中的该方法，并应有助于比较不同疗法。
Objective. To develop and validate the Vasculitis Damage Index (VDI) for the standardized clinical assessment of damage in the systemic vasculitides.Methods. Using a nominal group consensus approach, the Birmingham Vasculitis Group generated guiding principles for assessment of damage in all systemic vasculitides. Damage was defined as irreversible change resulting from scars, Consensus principles were developed into the VDI, including guidelines for use, a list of items of damage, and a glossary.Results. For 100 surviving patients with systemic vasculitis, the median VDI score at last observation was 3 (range 0-8), Within the Wegener's granulomatosis subgroup, the median VDI score for 12 non-survivors was higher than for 47 survivors (non-survivors median score 7, interquartile range 5-8 versus survivors median score 4, interquartile range 2-5; P = 0.003), VDI scores for 100 patients,vith systemic vasculitis increased from initial presentation to last observation by a median score of 3 (range 1-4; P < 0.001), The VDI assesses more items and is more sensitive to change than other indices of damage (P < 0.001), Using the VDI, trained observers can produce moderately consistent damage scores.Conclusion. The VDI is a sensitive, reproducible, comprehensive, and credible clinical tool for quantifying damage, The data presented herein should enable further validation and testing of the VDI in specific vasculitic syndromes, and should facilitate the comparison of different therapies.