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Development and validation of a nomogram for predicting fatigue in patients with primary Sjögren’s syndrome

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Abstract

Objective

To develop and validate a nomogram to predict fatigue in patients with primary Sjögren’s syndrome (pSS).

Methods

In this cross-sectional study, 251 patients with SS from the Affiliated Hospital of Nantong University were recruited. The patients were randomly divided into two groups: training group (n = 167) and validation group (n = 84). In the training group, univariate analysis and multivariate Cox regression analysis were performed on sociodemographic factors, disease activity, anxiety/depression, clinical indicators, and so on. According to the risk factors of fatigue in SS patients, a nomograph was established. In the training group and validation group, the performance of the nomogram was verified by three forms: receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA).

Result

The incidence of fatigue was 40.6%. EULAR Sjögren’s Syndrome Disease Activity Index, EULAR SS patient reported index, and depression were independent risk factors of fatigue in SS patients. The C-index of nomogram was 0.8532 in training set and 0.7381 in verification set, respectively. As to the Hosmer-Lemeshow test, the P value of modeling patients is 0.996 in verification (P > 0.05). DCA further validated the clinical utility of this nomogram.

Conclusion

The nomogram constructed in this study can effectively predict the occurrence of fatigue in SS patients, which is helpful for clinical decision-making and subsequent intervention implementation.

Key Points

• Fatigue was widespread in patients with primary Sjögren’s syndrome, and the incidence of fatigue was 40.6%.

• Disease activity and depression were independent risk factors of fatigue in patients with Sjögren’s syndrome.

• This was the first comprehensive nomogram to predict fatigue for Sjögren’s syndrome patients.

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Funding

This work was supported by Science and Technology Project of Nantong City (MSZ21043), National Natural Science Foundation of China (82201983, 82302048), Jiangsu Provincial Medical Key Discipline Cultivation Unit (JSDW202205), and Jiangsu Provincial Research Hospital (YJXYY202204).

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Authors and Affiliations

  1. Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China

    Rui Zhao, Chen Dong & Zhifeng Gu

  2. Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China

    Rui Zhao, Zhifeng Gu, Xiang Ding & Jing Li

  3. Medical College, Nantong University, 19th Qixiu Road, Nantong, 226001, China

    Chen Dong

  4. Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, China

    Xiang Ding

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  1. Rui Zhao
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Correspondence to Xiang Ding or Jing Li.

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Zhao, R., Dong, C., Gu, Z. et al. Development and validation of a nomogram for predicting fatigue in patients with primary Sjögren’s syndrome. Clin Rheumatol 43, 717–724 (2024). https://doi.org/10.1007/s10067-023-06853-9

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