Pos0816 HRCT Annual Score: It May Be Useful to Monitor HRCT Annual Score to Track Pulmonary Involvement in Systemic Sclerosis

Background: Systemic sclerosis (SSc) frequently affects the lung and interstitial lung disease (ILD) is a common manifestation and leading cause of mortality. Objectives: The study aimed to investigate the predictive power of annual change of HRCT score and annual change of forced vital capacity (FVC) on mortality. Methods: Patients with SSc associated ILD (SSc-ILD) who had HRCT at least twice with a one-year interval were included in the study. HRCT scoring system was used for assessment of SSc-ILD (Table 1). The annual change of HRCT score was calculated as last HRCT score minus initial HRCT score divided by the time (years) between last and initial HRCT. We also calculated the annual change in FVC as initial FVC minus last FVC divided by the time (years) between last and initial FVC. We performed a receiver operating characteristic (ROC) analysis for predictive power of the annual change of HRCT score and FVC. The cut of value of annual change of HRCT score and FVC was determined by maximum Youden Index. Results: A total of 100 patients were included in final analysis, mean age was 50,5±11,5 years and 91 (91%) patients were female. The median follow-up duration was 113.5 months (minimum-maximum: 17.0–196.0 months) and 19 (19%) patients died during follow-up period. ROC analysis showed that the annual change of HRCT score and the annual change of FVC had good predictive power for mortality (AUC: 0.69 and 0.65 respectively). Patients with an annual increase in HRCT score of more than 0.39 had 4.4 times higher risk for mortality compared to those without (95% CI, 1.7–11.2). Patients with an annual decrease in FVC of more than 77.6 mL had 5.2 times higher risk for mortality compared to those without (95% CI, 1.7–15.9) (Table 2). Both an increase in annual HRCT score and decrease in annual FVC indicate poor prognosis. Five of seven patients (71.4%) with an increase in annual HRCT score and decrease in FVC died during the follow-up period. Conclusion: We developed a parameter called the annual HRCT score to monitor the progression of patients with SSc-ILD. An increase in annual HRCT score indicates disease progression and associated with worse survival in patients with SSc-ILD. REFERENCES: [1] Moore, O. A., Goh, N., Corte, T., Rouse, H., Hennessy, O., Thakkar, V.,... & Nikpour, M. (2013). Extent of disease on high-resolution computed tomography lung is a predictor of decline and mortality in systemic sclerosis-related interstitial lung disease. Rheumatology, 52(1), 155-160. Acknowledgements: NIL. Disclosure of Interests: None declared.