. Departamento de Pneumologia, Universidade Federal de São Paulo, São Paulo (SP) Brasil.
J Bras Pneumol. 2022 Feb 2;48(1):e20210366. doi: 10.36416/1806-3756/e20210366. eCollection 2022.
To identify predictive features associated with the course of sarcoidosis at initial evaluation and to develop a predictive score.
This was a retrospective study involving pulmonary sarcoidosis patients, classified as having a self-limited or persistent course of disease, comparing data between the outcomes by univariate analysis. Features related to persistent disease were selected by multivariate analysis and a prognostic score was designed.
The sample comprised 200 patients (mean age = 49 years). The median duration of symptoms to diagnosis was 12 months, and delayed diagnosis (> 12 months) was found in 43% of the cases. The most common radiological stage was II; 37% had reduced FVC. Relevant systemic involvement was detected in 37% of the patients. Treatment for tuberculosis was prescribed in 44 patients prior to sarcoidosis diagnosis. Treatment for sarcoidosis was required in 77% of the sample, and the disease course was persistent in 115 cases. Excluding 40 patients with fibrotic disease, prognostic factors to persistent disease were parenchymal involvement, delayed diagnosis, dyspnea, relevant systemic involvement, and reduced FVC. On the basis of the analysis, a 3-letter scoring system (A, B and C) was developed according to the selected factors. The positive predictive values for persistent course for A (≤ 1 point) and C scores (≥ 4 points) were 12.5% and 81.8%, respectively.
A score can be derived by selected features at initial evaluation, allowing the prediction of outcomes in a significant number of sarcoidosis patients.
确定在初次评估时与结节病病程相关的预测特征，并制定预测评分。
这是一项回顾性研究，涉及肺结节病患者，根据疾病的自限性或持续性分为两类，通过单变量分析比较两组间结局数据。通过多变量分析选择与持续性疾病相关的特征，并设计预测评分。
样本包括 200 例患者（平均年龄 49 岁）。症状到诊断的中位时间为 12 个月，43%的病例存在延迟诊断（>12 个月）。最常见的放射学分期为 II 期；37%的患者存在 FVC 降低。37%的患者存在明显的全身受累。在结节病诊断前，44 例患者曾接受过肺结核治疗。77%的患者需要接受结节病治疗，115 例患者的病程持续存在。排除 40 例纤维化患者后，与持续性疾病相关的预测因素包括实质受累、延迟诊断、呼吸困难、全身受累和 FVC 降低。在此基础上，根据所选因素制定了一个 3 字母评分系统（A、B 和 C）。A（≤1 分）和 C（≥4 分）评分的持续性疾病阳性预测值分别为 12.5%和 81.8%。
在初次评估时，可以通过选择的特征得出评分，从而对大量结节病患者的预后进行预测。
