| spelling |
Gilda Aparecida Ferreirahttp://lattes.cnpq.br/1174231810871974http://lattes.cnpq.br/3028174364018982Marcela Paula Santos Penteado2023-09-26T16:02:51Z2023-09-26T16:02:51Z2023-05-25http://hdl.handle.net/1843/58944Objetivo Investigar a relação entre dano estrutural em coluna e capacidade funcional em pacientes com espondiloartrite (EpA) axial, e comparar a força da associação de dois escores radiográficos [modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) e Combined Ankylosing Spondylitis Spine Score (CASSS)] com a variável clínica supracitada. Métodos Radiografias de 101 pacientes consecutivos com diagnóstico de EpA axial foram avaliadas por três leitores de acordo com o método proposto por de Vlam et al. para articulações facetárias cervicais [cervical facet joint (CFJ) score] e de acordo com o mSASSS para corpos vertebrais. O CASSS foi calculado como o somatório de ambos os escores. A função física foi avaliada pelo Bath Ankylosing Spondylitis Functional Index (BASFI), atividade de doença pelo Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) e pelo Ankylosing Spondylitis Disease Activity Score (ASDAS), mobilidade pelo Bath Ankylosing Spondylitis Metrology Index (BASMI) e qualidade de vida pelo Ankylosing Spondylitis Quality of Life (ASQOL). As correlações entre os parâmetros clínicos e os escores radiográficos foram analisadas pelo coeficiente de correlação de Spearman. Análises univariada e multivariada foram realizadas para investigar a associação entre os desfechos e possíveis variáveis explanatórias. Os efeitos da idade, sexo, duração dos sintomas, tabagismo e história de artroplastia total do quadril (ATQ) também foram explorados nos modelos de regressão linear multivariada. Resultados O BASFI se correlacionou fortemente com o ASQoL (rô de Spearman = 0,655; p < 0,001) e o BASDAI (rô = 0,699; p < 0,001), moderadamente com o BASMI (rô = 0,457; p < 0,001) e o ASDAS (rô = 0,586; p < 0,001) e fracamente com o mSASSS (rô = 0,285; p = 0,004) e o CASSS (rô = 0,275; p = 0,005). O BASDAI (B = 0,761; p <0,001), o BASMI (B = 0,617; p <0,001) e ATQ (B = 1,218; p = 0,050) apresentaram associação com a variável desfecho BASFI, após ajuste do modelo multivariado para duração dos sintomas, idade, sexo e tabagismo. Os escores radiográficos foram preditores do BASFI apenas quando o BASMI foi removido do modelo: mSASSS (B = 0,026; p = 0,012) e CASSS (B = 0,024; p = 0,005). Conclusão No presente estudo, o dano estrutural em coluna foi associado de forma independente à função física nas EpA axiais, mas com menor impacto na função do que a atividade de doença e a mobilidade. Além disso, incorporar a avaliação das articulações facetárias cervicais ao mSASSS não aumentou sua capacidade de predizer função.Objective To investigate the relationship between structural damage of the spine and functional capacity in patients with axial spondyloarthritis (axSpA) and to compare the strength of the association of two radiographic scores [modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and Combined Ankylosing Spondylitis Spine Score (CASSS)] with the clinical variable mentioned above. Methods Radiographs from 101 consecutive axSpA patients were scored by three readers according to the method of de Vlam et al. for cervical facet joints (CFJ) and according to the mSASSS for vertebral bodies. CASSS was calculated as the sum of both scores. Physical function was assessed by the Bath Ankylosing Spondylitis Functional Index (BASFI), disease activity by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), mobility by the Bath Ankylosing Spondylitis Metrology Index (BASMI) and quality of life by the Ankylosing Spondylitis Quality of Life (ASQOL). Correlations between clinical parameters and radiographic scores were analyzed by Spearman’s test. Univariate and multivariate analyses were performed to investigate the association between outcomes and possible explanatory variables. Contributory effects of age, sex, symptoms duration, smoking and history of total hip arthroplasty (THA) were also explored in the multivariate linear regression models. Results BASFI correlated strongly with ASQoL (Spearman’s rho = 0.655; p < 0.001) and BASDAI (Spearman’s rho = 0.699; p < 0.001), moderately with BASMI (Spearman’s rho = 0.457; p < 0.001) and ASDAS (Spearman’s rho = 0.586; p < 0.001) and weakly with mSASSS (Spearman’s rho = 0.285; p = 0.004) and CASSS (Spearman’s rho = 0.275; p = 0.005). A best-fit multivariate model for BASFI, adjusted for symptoms duration, age, sex and smoking status, included BASDAI (B = 0.761; p < 0.001), BASMI (B = 0.617; p < 0.001) and THA (B = 1.218; p = 0.050). Radiographic scores were predictors of the BASFI only when BASMI was removed from the model: mSASSS (B = 0.026; p = 0.012) and CASSS (B = 0.024; p = 0.005). Conclusion In the present study, spinal damage was independently associated with physical function in axSpA but to a lesser extent than disease activity and mobility. Moreover, incorporating cervical facet joints assessment in the mSASSS did not increase its strength in predicting functionporUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em Ciências Aplicadas à Saúde do AdultoUFMGBrasilMEDICINA - FACULDADE DE MEDICINAhttp://creativecommons.org/licenses/by-nc-nd/3.0/pt/info:eu-repo/semantics/openAccessEspondiloartrite AxialRadiografiaPadrões de ReferênciaÍndice de Gravidade de DoençaCorrelação de DadosDissertação AcadêmicaEspondiloartrite axialDano estruturalDano estrutural em coluna e capacidade funcional nos pacientes com espondiloartrite axialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALVersão Repositório corrigida.pdfVersão Repositório corrigida.pdfapplication/pdf1187687https://repositorio.ufmg.br/bitstream/1843/58944/3/Vers%c3%a3o%20Reposit%c3%b3rio%20corrigida.pdf71804144132b9286a8a8f716a566c6b8MD53CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufmg.br/bitstream/1843/58944/4/license_rdfcfd6801dba008cb6adbd9838b81582abMD54LICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/58944/5/license.txtcda590c95a0b51b4d15f60c9642ca272MD551843/589442023-09-26 13:02:52.091oai:repositorio.ufmg.br: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ório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-09-26T16:02:52Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
|