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Screening tool development for hand surgery referrals in systemic sclerosis.

Marcos Felipe Marcatto de Abreu1, Síbila Landim2, Fernanda Yuri Yuamoto1

  • 1Department of Orthopedics, Rheumatology and Traumatology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil.

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Systemic sclerosis patients with digital ulcers show a high likelihood of needing hand surgery. Identifying digital ulcers can help rheumatologists optimize surgical referrals for these patients.

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Area of Science:

  • Rheumatology
  • Surgical Referral Optimization
  • Hand Impairment in Systemic Sclerosis

Background:

  • Systemic Sclerosis (SSc) is a connective tissue disease that can cause significant hand impairment.
  • Hand surgery may be a necessary intervention for SSc patients experiencing functional limitations.

Purpose of the Study:

  • To develop and validate a screening tool for rheumatologists.
  • To identify SSc patients who are optimal candidates for hand surgery.
  • To improve the efficiency of surgical referrals in SSc care.

Main Methods:

  • A pilot cross-sectional study was conducted with 51 participants meeting ACR/EULAR criteria for SSc and hand impairment.
  • Data collected included demographics, disease characteristics, and functional status.
  • Multivariate logistic regression analysis was used to identify predictors of surgical candidacy.

Main Results:

  • 68.8% of participants met criteria for hand surgery.
  • Digital Ulcers (DU) were present in 91.43% of the surgical group versus 18.75% of the non-surgical group (p < 0.0010).
  • The presence of DU significantly increased the likelihood of surgical indication (OR 46.2), with the model demonstrating high accuracy (86.3%), sensitivity (91.4%), and specificity (81.2%).

Conclusions:

  • Digital Ulcers (DU) in Systemic Sclerosis (SSc) patients are a strong indicator for potential hand surgery.
  • The presence of DU can serve as a key screening feature for early identification and referral.
  • This facilitates timely surgical intervention and optimizes outcomes for SSc patients with hand impairment.