Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Scand J Rheumatol. 2020 May;49(3):221-224. doi: 10.1080/03009742.2019.1707280. Epub 2020 Mar 12.
: To evaluate the influence of low socioeconomic status (SES) on mortality among patients with granulomatosis with polyangiitis (GPA).: Using nationwide registers, we established a cohort of 827 patients diagnosed with GPA in the public hospital system of Denmark. For each patient, information regarding educational level, civil status, employment status, and comorbidities at time of GPA diagnosis was collected. We used Cox regression analyses to calculate hazard ratios (HRs) adjusted for age, gender, calendar period of GPA diagnosis, and Charlson Comorbidity Index score for preceding illnesses as a measure of relative risk of death. We assessed the risk of death associated with three measures of low SES: basic schooling only, civil status as single, and being unemployed or recipient of disability pension.: The median age of patients at GPA diagnosis was 61 (interquartile range 51-69) years, and 508 were 18-64 years old. During a total of 4337 person-years, 237 patients died. Among patients aged 18-64 years at GPA diagnosis, all three measures of low SES were identified as risk factors for death [basic schooling only: HR = 2.04, 95% confidence interval (CI) 1.30-3.19; civil status as single: HR = 1.95, 95% CI 1.24-3.05; being unemployed or recipient of disability pension: HR = 2.96, 95% CI 1.72-5.08]. The association between low SES and mortality was less pronounced among patients aged ≥ 65 years.: Our observations indicate that low SES is associated with increased mortality in GPA, especially among patients of working age.
评估低社会经济地位(SES)对肉芽肿性多血管炎(GPA)患者死亡率的影响。
我们使用全国性登记册,建立了丹麦公立医院系统中 827 名 GPA 患者的队列。对于每位患者,收集了诊断 GPA 时的教育程度、婚姻状况、就业状况和合并症的信息。我们使用 Cox 回归分析计算了校正年龄、性别、GPA 诊断的日历时间段和 Charlson 合并症指数得分的危害比(HRs),作为死亡相对风险的衡量标准。我们评估了三种低 SES 措施与死亡风险的关联:仅接受基本教育、单身婚姻状况和失业或领取残疾抚恤金。
患者 GPA 诊断时的中位年龄为 61 岁(四分位距 51-69 岁),508 岁为 18-64 岁。在总共 4337 人年期间,有 237 名患者死亡。在 GPA 诊断时年龄为 18-64 岁的患者中,所有三种低 SES 措施均被确定为死亡的危险因素[仅接受基本教育:HR=2.04,95%置信区间(CI)为 1.30-3.19;单身婚姻状况:HR=1.95,95%CI 为 1.24-3.05;失业或领取残疾抚恤金:HR=2.96,95%CI 为 1.72-5.08]。在年龄≥65 岁的患者中,低 SES 与死亡率之间的关联不那么明显。
我们的观察结果表明,低 SES 与 GPA 患者的死亡率增加相关,尤其是在处于工作年龄的患者中。