Mortality of Jamaican Patients With Systemic Lupus Erythematosus

Harris, Edward N.; Williams, Erik A.; Shah, D; Ceulaer, Karel De

doi:10.1093/rheumatology/28.2.113

Cited by 24 publications

(8 citation statements)

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“…This is in concordance with data from other centers. Table 7 summarizes the survival experience of other lupus cohorts(3, 5, 7–12, 14, 16, 19, 22, 24–26, 29, 32, 35, 38, 41, 42, 57, 64–70). Although our 5‐year survival rate is lower than the one described in primarily Caucasian cohorts (Europe, Canada), it is the same as or better than the survival rates for contemporary US cohorts that have a significant representation of African Americans, and it is much higher than the survival rates for cohorts from developing countries.…”

Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus in three ethnic groups. VIII. Predictors of early mortality in the LUMINA cohort

Alarcón

McGwin

Bastian

et al. 2001

Arthritis & Rheumatism

299

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Objective To determine the features associated with mortality in a multiethnic US cohort of patients with systemic lupus erythematosus (SLE) within 5 years of study onset. Methods Socioeconomic and demographic features (age, gender, ethnicity, marital status, education, occupation, poverty, and health‐related behaviors [drinking, smoking, exercising]), clinical and immunologic features (disease duration, disease onset type, disease activity according to the Systemic Lupus Activity Measure [SLAM], disease damage according to the Systemic Lupus International Collaborating Clinics [SLICC] Damage Index [SDI], number of American College of Rheumatology criteria at diagnosis, organ system manifestations, fatigue and pain ratings, and medication usage and autoantibodies), immunogenetic features (HLA class II genotypes), and behavioral and psychosocial features (social support, illness‐related behaviors, and helplessness), as obtained at enrollment into the study, were compared between survivors and deceased patients. Logistic regression analysis was used to determine significant independent risk factors for mortality. Results Within 5 years of study onset, 34 of 288 patients have died. Fourteen deaths could be directly attributed to SLE and 11 to infections. In 1 patient the cause of death could not be determined. In the remaining 8 patients the cause of death was neither infectious nor disease‐related. There were 10 deaths among Hispanics, 18 among African Americans, and 6 among Caucasians (P< 0.05). Variables associated with mortality in the univariable analyses included poverty, less than full‐time employment, difficulty in accessing health care, shorter disease duration, cardiovascular and renal involvement, higher serum creatinine levels and lower hematocrit values, higher SLAM and SDI scores, lower use of antimalarial drugs, and higher use of (some) immunosuppressants. Specific autoantibodies and class II HLA genotypes were not associated with mortality. Poverty and higher baseline SLAM and SDI scores were independently associated with mortality in the multivariable analyses. Conclusions Disease activity, disease damage, and poverty appear to be the most important determinants of mortality in this multiethnic US cohort of SLE patients. These results have applicability to the management of patients with SLE, a disease that more severely affects disadvantaged minority population groups.

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Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus in three ethnic groups. VIII. Predictors of early mortality in the LUMINA cohort

Alarcón

McGwin

Bastian

et al. 2001

Arthritis & Rheumatism

299

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“…S I E in African Caribbeans. Data concerning SLE in the West Indies (40)(41)(42)(43)(44)(45)(46) are limited. Wilson and Hughes (45) showed the relatively high prevalence of SLE in hospitalized patients in Jamaica.…”

Section: Sle In Africansmentioning

confidence: 99%

The epidemiology of systemic lupus erythematosus in populations of African ancestry: A critical review of the ?prevalence gradient hypothesis?

Bae

Fraser

Liang

1998

Arthritis & Rheumatism

100

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“…Important differences were detected in clinical and immunogenetic variables that could help identify associations with clinical manifestations, disease activity, and physician's global scores. The epidemiology of SLE has been evaluated mainly in North America [2][3][4][5][6][7][8][9][10][11]21,27,29,48,[54][55][56]64,76,77,81,84 and in some European countries 17,19,20,[38][39][40]42,46 , but little information is available from Latin America 1,16,22,23,26,36,37,41,47,49,51,52,65,79 . For obvious reasons, the Latin American studies make few comparisons between ethnic groups, although some have shown a poor prognosis and a high prevalence of infections in African-Latin American (ALA) SLE patients, both of which may relate to socioeconomic variables.…”

Section: Introductionmentioning

confidence: 99%

The GLADEL Multinational Latin American Prospective Inception Cohort of 1,214 Patients With Systemic Lupus Erythematosus

et al. 2004

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Clinical and laboratory manifestations and outcome of systemic lupus erythematosus (SLE) may vary in different populations. A prospective multinational inception cohort should prove useful in identifying the influence of ethnicity on the clinical characteristics of SLE. We therefore analyzed clinical, laboratory, and prognostic variables in Latin American SLE patients with disease of recent onset who were entered into a prospective cohort, and compared these variables in the cohort's 3 major ethnic groups. Thirty-four centers from 9 Latin American countries participated by randomly incorporating SLE patients within 2 years of diagnosis into a standardized database. Participating centers were selected for their expertise in diagnosing and managing SLE. We were then able to evaluate prospectively socioeconomic variables, ethnicity, type of medical care, clinical and laboratory features, disease activity, damage, and mortality at each site. A coordinating center controlled the quality of the information submitted. Of the 1,214 SLE patients included in the cohort, 537 were mestizos, 507 were white, and 152 were African-Latin American (ALA). (There were also small numbers of pure Amerindian and oriental individuals.) Significant differences were found between them in socioeconomic characteristics, type of care, and level of education favoring whites. Mestizos and ALA were younger at onset. Delay to diagnosis and disease duration was shorter in ALA. Fever was more frequent in whites; discoid lesions in ALA; renal disease and lymphopenia in mestizos and ALA. Although we found differences in background variables between ethnic groups from different countries, mestizos from 2 distant countries (Argentina and Mexico) were clinically akin and showed similar differences to whites. Mortality was associated with lower education, poor medical coverage, and shorter follow-up. In an exploratory model nonwhite ethnicity was associated with renal disease and lymphopenia, damage, and cumulative American College of Rheumatology criteria. These differences in clinical, prognostic, socioeconomic, educational, and access to medical care features in Latin American lupus patients of 3 major ethnic groups from 9 different countries may have an impact on the patients' disease. "Hispanics," as they have come to be generically termed on the basis of language, actually constitute a markedly heterogeneous group of subjects.

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Mortality of Jamaican Patients With Systemic Lupus Erythematosus

Cited by 24 publications

References 0 publications

Systemic lupus erythematosus in three ethnic groups. VIII. Predictors of early mortality in the LUMINA cohort

Systemic lupus erythematosus in three ethnic groups. VIII. Predictors of early mortality in the LUMINA cohort

The epidemiology of systemic lupus erythematosus in populations of African ancestry: A critical review of the ?prevalence gradient hypothesis?

The GLADEL Multinational Latin American Prospective Inception Cohort of 1,214 Patients With Systemic Lupus Erythematosus

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