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Updated: Jan 20, 2026
Cross-Modal Multivariate Pattern Analysis
Published on: November 9, 2011
Multivariable index for assessing the activity and predicting all-cause mortality in antineutrophil cytoplasmic
Minyoung Kevin Kim1, Hyeok Choi1, Jae Yeon Kim1
1Department of Medicine, Yonsei University College of Medicine, Seoul, Korea.
Insights
A new Multivariable Index for AAV (MVIA) helps estimate disease severity and predict mortality in ANCA-associated vasculitis patients. This tool aids in assessing activity at diagnosis and forecasting outcomes.
Area of Science:
- Rheumatology
- Nephrology
- Internal Medicine
Background:
- ANCA-associated vasculitis (AAV) lacks tools for assessing disease activity and predicting mortality at diagnosis.
- Identifying predictors of severe AAV and all-cause mortality is crucial for patient management.
Purpose of the Study:
- To determine initial predictors of disease activity and all-cause mortality in patients with AAV.
- To develop and validate a new index for assessing AAV severity and predicting patient survival.
Main Methods:
- Retrospective review of 182 AAV patients.
- Definition of severe AAV using Birmingham Vasculitis Activity Score (BVAS) ≥ 16.
- Multivariable logistic regression and chi-square tests to identify predictors and assess risk.
Main Results:
- Severe AAV associated with higher neutrophil/platelet counts, creatinine, ESR, CRP; lower lymphocyte count, hemoglobin, albumin.
- Predictors of severe AAV: creatinine ≥ 0.9 mg/dL, lymphocyte count ≤ 1430.0/mm³, hemoglobin ≤ 10.8 g/dL.
- Developed Multivariable Index for AAV (MVIA) equation; MVIA ≥ 1.35 identified severe AAV (RR 4.432) and predicted lower survival.
Conclusions:
- The Multivariable Index for AAV (MVIA) effectively assesses cross-sectional disease activity.
- MVIA serves as a valuable tool for predicting all-cause mortality in AAV patients.
Background:
So far, there has been no tool to estimate activity at diagnosis and predict all-cause mortality in patients with ANCA-associated vasculitis (AAV). Hence, we determined the initial predictors of them in patients with AAV.
Methods:
We retrospectively reviewed the medical records of 182 patients with AAV. Severe AAV was defined as Birmingham Vasculitis Activity Score (BVAS) ≥ 16. The cutoffs were extrapolated by the receiver operator characteristic (ROC) curve. The odds ratio (OR) and the relative risk (RR) were assessed using the multivariable logistic regression analysis and the chi-square test, respectively.
Results:
In the comparison analysis, patients with severe AAV exhibited the higher neutrophil and platelet counts, creatinine, erythrocyte sedimentation rate and C-reactive protein, and the lower lymphocyte count, hemoglobin, and serum albumin than those without. In the multivariable logistic regression analysis, creatinine ≥ 0.9 mg/dL (OR 2.264), lymphocyte count ≤ 1430.0/mm3 (OR 1.856), and hemoglobin ≤ 10.8 g/dL (OR 2.085) were associated with severe AAV. We developed a new equation of a multivariable index for AAV (MVIA) = 0.6 × (Lymphocyte count ≤ 1430.0/mm3 ) + 0.7 × (Hemoglobin ≤ 10.8 g/dL) + 0.8 × (Creatinine ≥ 0.9 mg/dL). The optimal cutoff of MVIA for severe AAV was set as 1.35. Severe AAV was identified more frequently in patients with MVIA at diagnosis ≥1.35 than those without (RR 4.432). Patients with MVIA at diagnosis ≥1.35 exhibited the lower cumulative patient survival rate than those without.
Conclusion:
Multivariable index for AAV could assess the cross-sectional activity and predict all-cause mortality in patients with AAV.
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