A Nomogram Predicting Decreased Quality of Life in Patients with Keloids

Purpose: Most keloid patients have a low quality of life (QoL), which affects their prognosis. Our aim was to identify risk factors for a decreased QoL in patients with keloids and to create a predictive nomogram for this condition. Patients and Methods: The Dermatology Life Quality Index (DLQI) is used to assess patients’ QoL, with a DLQI score > 10 indicated a decreased QoL. We used multivariate logistic regression to assess QoL in patients with keloids for predictive modeling. We assessed the predictive and clinical value of the nomograms using the consistency index (C-index), area under the curve (AUC), and decision curve analysis (DCA). Results: The risk factors that associated with a decreased QoL in patients with keloids are smoking (OR = 2.463, 95% CI = 1.031– 5.880, P = 0.042), pain with pruritus (OR = 2.647, 95% CI = 1.232– 5.684, P = 0.013), and anxiety (OR = 5.294, 95% CI = 2.158– 12.987, P < 0.001). The C-index of the nomogram was 0.704 (95% CI = 0.675– 0.733), with the AUC of 0.714 (95% CI = 0.634– 0.792). The results of the DCA suggest that the model is clinically beneficial when the risk threshold is between 0% and 79%. Internal validation indicates that nomograms could be more effectively utilized in clinical practice. Conclusion: Our study found that people with keloids currently experience a poor QoL, and that nomograms can assist dermatologists in predicting which patients are at higher risk for a further decline in QoL. Keywords: keloids, quality of life, nomogram, anxiety