Yang Grace, Bykerk Vivian P, Boire Gilles, Hitchon Carol A, Thorne J Carter, Tin Diane, Haraoui Boulos, Keystone Edward C, Pope Janet E
From the Schulich School of Medicine and Dentistry, Department of Internal Medicine, University of Western Ontario, London, Ontario, Canada; Rheumatology, Hospital for Special Surgery, Cornell University, New York, New York, USA; Rheumatology Division, Université de Sherbrooke, Sherbrooke, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Southlake Regional Health Centre, Newmarket, Ontario; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto; Rheumatology, St. Joseph's Health Care, London, Ontario, Canada.G. Yang, MD, Schulich School of Medicine and Dentistry, Department of Internal Medicine, University of Western Ontario; V.P. Bykerk, MD, FRCPC, Rheumatology, Hospital for Special Surgery, Cornell University; G. Boire, MD, FRCPC, Rheumatology Division, Universite de Sherbrooke; C.A. Hitchon, MD, FRCPC, Arthritis Centre, University of Manitoba; J.C. Thorne, MD, FRCPC; D. Tin, BSc Pharm, Southlake Regional Health Centre; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; E.C. Keystone, MD, FRCPC, Rheumatology, Mount Sinai Hospital, University of Toronto; J.E. Pope, MD, FRCPC, MPH, Schulich School of Medicine and Dentistry, Department of Internal Medicine, University of Western Ontario, and Rheumatology, St. Joseph's Health Care.
J Rheumatol. 2015 Jan;42(1):46-54. doi: 10.3899/jrheum.131382. Epub 2014 Nov 15.
To assess the effect of socioeconomic status (SES) on outcomes in patients with early inflammatory arthritis, using data from the Canadian Early Arthritis Cohort (CATCH) study.
In an incident cohort, 2023 patients were recruited, and allocated to low SES or high SES groups based on education and income. Outcomes at baseline and 12 months were analyzed in relation to SES including the 28-joint Disease Activity Score (DAS28), Simplified Disease Activity Index (SDAI), pain, patient's global assessment scale (PtGA), the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the SF12-v2 Health Survey, using the ANOVA, chi-squared test, and regression analyses.
The CATCH population had 43% with high school education or less and 37% in the low-income group (< 50,000 Can$ per annum household income). The low-education group had higher DAS28 at baseline (p = 0.045), becoming nonsignificant at 12 months and lower physical component score on SF12-v2 at baseline (p = 0.022). Patients in the low-income group presented with higher HAQ-DI (p = 0.017), pain (p = 0.035), PtGA (p = 0.004), and SDAI (p = 0.022). Low-income versus high-income groups were associated with an OR above the median for HAQ-DI (1.20; 95% CI 1.00-1.45), PtGA (1.27; 95% CI 1.06-1.53), and SDAI (1.25; 95% CI 1.02-1.52) at baseline. The association with low income persisted at 12 months for HAQ-DI (OR 1.30; 95% CI 1.02-1.67), but not for other variables.
Low SES was initially associated with higher disease activity, pain, and PtGA, and poorer function. At 1 year, outcomes were similar to those with high SES, with the exception of HAQ-DI.
利用加拿大早期关节炎队列（CATCH）研究的数据，评估社会经济地位（SES）对早期炎性关节炎患者预后的影响。
在一个新发病例队列中，招募了2023名患者，并根据教育程度和收入将其分为低SES组或高SES组。使用方差分析、卡方检验和回归分析，分析了与SES相关的基线和12个月时的预后情况，包括28个关节疾病活动评分（DAS28）、简化疾病活动指数（SDAI）、疼痛、患者整体评估量表（PtGA）、健康评估问卷残疾指数（HAQ-DI）以及SF12-v2健康调查。
CATCH队列中有43%的人接受过高中及以下教育，37%的人属于低收入组（家庭年收入低于50,000加元）。低教育组在基线时的DAS28较高（p = 0.045），在12个月时变得不显著，且在基线时SF12-v2的身体成分评分较低（p = 0.022）。低收入组的患者HAQ-DI较高（p = 0.017）、疼痛（p = 0.035）、PtGA（p = 0.004）和SDAI（p = 0.022）。在基线时，低收入组与高收入组相比，HAQ-DI（1.20；95%可信区间1.00 - 1.45）、PtGA（1.27；95%可信区间1.06 - 1.53）和SDAI（1.25；95%可信区间1.02 - 1.52）的比值比高于中位数。对于HAQ-DI，低收入与高收入组之间的关联在12个月时仍然存在（比值比1.30；95%可信区间1.02 - 1.67），但其他变量不存在这种关联。
低SES最初与较高的疾病活动度、疼痛和PtGA以及较差的功能相关。在1年时，除HAQ-DI外，预后情况与高SES组相似。
