46-Year Trends in Systemic Lupus Erythematosus Mortality in the United States, 1968 to 2013

Yen, Eric Y; Shaheen, Magda; Woo, Jennifer M.P.; Mercer, Neil; Li, Ning; McCurdy, Deborah; Karlamangla, Arun S.; Singh, Ram Raj

doi:10.7326/m17-0102

Cited by 135 publications

(126 citation statements)

References 26 publications

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“…The cause of increased mortality in these groups is not clear given the relatively small number of deaths in any one group. However, a recent report from the Centers for Disease Control and Prevention found increased mortality among Blacks compared to other racial groups for all age ranges under 65 though this gap had narrowed recently [33] and a study by Yen et al showed that decreases in lupus mortality over the last 46 years were slower in Blacks individuals compared to White individuals [34]. Among adolescents with cancer, an increase in mortality rates among African Americans was found to be mainly associated with insurance status and socioeconomic status [35] which also seemed to be at play in our study though it was not significant and not included in the final model.…”

Section: Discussionmentioning

confidence: 98%

Inpatient mortality in transition-aged youth with rheumatic disease: an analysis of the National Inpatient Sample

Jensen¹,

Koh²,

Cash³

et al. 2020

Pediatr Rheumatol

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Background: Transition from pediatric to adult care is a vulnerable time for youth with chronic diseases. In youth with rheumatic disease, studies show high rates of loss to follow up and increased disease activity. However, mortality data are lacking. In this study, we assessed whether transitional age is a risk factor for inpatient mortality. Methods: We analyzed the 2012-2014 National Inpatient Sample database, a representative sample of discharges in the United States. Individuals with rheumatic diseases were identified by International Statistical Classification of Disease-9 (ICD-9) codes at time of discharge. Youth were categorized into three age groups: pre-transitional (11-17), transitional (18-24) and post transitional (25-31). We fitted univariable and multivariable logistic regression models to assess whether transitional age was a risk factor for inpatient mortality. Results: There were 30,269 hospital discharges which met our inclusion criteria of diagnosis and age. There were 195 inpatient deaths (0.7%). The most common causes of death were infection (39.5%), pulmonary disease (13.8%), and cardiac disease (11.2%). The Odds ratio for inpatient mortality of a transitional-aged individual was 1.18 compared to controls (p = 0.3). Black race (OR = 1.4), male sex (OR = 1.75), and a diagnosis of systemic sclerosis (OR = 4.81) or vasculitis (OR = 2.85) were the greatest risk factors of inpatient mortality. Conclusion: Transitional age was not a risk factor for inpatient mortality in this study. We did identify other risk factors other than age. Further studies are required to assess if there is an increased risk of mortality in outpatients of the transitional age group.

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Section: Discussionmentioning

confidence: 98%

Inpatient mortality in transition-aged youth with rheumatic disease: an analysis of the National Inpatient Sample

Jensen¹,

Koh²,

Cash³

et al. 2020

Pediatr Rheumatol

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“…Systemic lupus erythematosus (SLE) is a complex autoimmune disease that involves diverse organ systems. With advances in patient management, the survival of patients with SLE has improved, and most patients now survive for decades following diagnosis …”

Section: Introductionmentioning

confidence: 99%

Identifying damage clusters in patients with systemic lupus erythematosus

Ahn

Lee²,

Won³

et al. 2019

Int J of Rheum Dis

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Aim Systemic lupus erythematosus (SLE) causes irreversible damage to organ systems. Recently, evidence has been obtained for subphenotypes of SLE. This study aimed to identify damage clusters and compare the associated clinical manifestations, SLE disease activity, mortality, and genetic risk scores (GRS). Methods The study was conducted on the Hanyang BAE lupus cohort. Patients with disease duration <5 years were excluded to minimize confounding effects of disease duration. They were grouped into 3 clusters based on the Systemic Lupus International Collaborating Clinics Damage Index using k‐means cluster analysis. Results Among the 1130 analyzed patients, musculoskeletal damage was most prevalent (20.2%), followed by ocular (11.4%), renal (10.5%), and neuropsychiatric damage (10.2%). Three significantly different damage clusters were identified. Patients in cluster 1 (n = 824) showed the least damage. Cluster 2 (n = 195) was characterized by frequent renal (55.4%) and ocular (58.0%) damage, and cluster 3 (n = 111) was dominated by neuropsychiatric (100%) and musculoskeletal damage (35.1%). Cluster 2 had the highest adjusted mean AMS (adjusted mean SLE Disease Activity Index score; mean ± SD: 5.4 ± 2.9), while cluster 3 had the highest mortality (14.4%). Weighted GRS did not differ significantly between the clusters. Conclusion Patients in prevalent renal and ocular damage cluster had the highest AMS scores, while the cluster with frequent neuropsychiatric damage had the highest mortality.

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“…заболевания [2][3][4][5][6]. Среди пациентов с СКВ до 90% составляют женщины детородного возраста, при этом пик заболеваемости приходится на возраст 15-25 лет [2,7].…”

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“…Несмотря на это, возможности современной патогенетической терапии привели к значительному снижению летальности от СКВ, составлявшей 50% в докортикостероидный период (до 1948 г. ), и достижению показателя 15-летней выживаемости у 85-95% пациентов в настоящее время [2][3][4].…”

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Clinical and laboratory relationships in patients with different variants of the course of systemic lupus erythematosus

Лила

2020

Sovremennaâ revmatologiâ

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Systemic lupus erythematosus (SLE) is characterized by a variability in clinical manifestations and laboratory abnormalities, which creates objective diagnostic difficulties.Objective: to investigate clinical and laboratory parameters in patients with definite and probable SLE.Patients and methods. The investigation enrolled 94 patients, 38 of whom were diagnosed with probable SLE. All the patients underwent immunological examination and unaffected skin biopsies, followed by an immunohistochemical study, the so-called lupus strip test (LST).Results and discussion. The group of patients with definite SLE showed a direct correlation between positive LST and disease activity (r=0.6), acute skin lesion (r=0.42), and elevated anti-double-stranded DNA antibody concentrations (r=0.37), and their inverse correlation with dry syndrome (r=-0.44). In patients with probable SLE, deposition of immunoreactants in the unaffected skin was detected in almost half of the cases, despite lower disease activity and specific antibody deficiency. Thus, LST that is quite easy to use and interpret its results can be used as an additional criterion for the differential diagnosis of SLE, especially in its early stages.

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46-Year Trends in Systemic Lupus Erythematosus Mortality in the United States, 1968 to 2013

Cited by 135 publications

References 26 publications

Inpatient mortality in transition-aged youth with rheumatic disease: an analysis of the National Inpatient Sample

Inpatient mortality in transition-aged youth with rheumatic disease: an analysis of the National Inpatient Sample

Identifying damage clusters in patients with systemic lupus erythematosus

Clinical and laboratory relationships in patients with different variants of the course of systemic lupus erythematosus

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