Western University and St. Joseph's Health Care, London, Ontario, Canada.
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Arthritis Care Res (Hoboken). 2022 Aug;74(8):1294-1299. doi: 10.1002/acr.24573. Epub 2022 May 24.
Reports of mortality risks among individuals with giant cell arteritis (GCA) have been mixed. Our aim was to evaluate all-cause mortality among individuals with GCA relative to the general population over time.
We performed a population-based study in Ontario, Canada using health administrative data. We studied a cohort of 22,677 GCA patients ages ≥50 years that was identified using a validated case definition (with 81% positive predictive value, 100% specificity). General population comparators were residents ages ≥50 years without GCA. Deaths were ascertained from vital statistics. Annual crude, age- and sex-standardized, and age- and sex-specific all-cause mortality rates were determined for individuals with and without GCA between 2000 and 2018. Standardized mortality ratios (SMRs) were estimated.
Age- and sex-standardized mortality rates were significantly higher for GCA patients than comparators, and trending to increase over time with 50.0 deaths per 1,000 GCA patients in 2000 (95% confidence interval [95% CI] 34.0-71.1) and 57.6 deaths per 1,000 GCA patients in 2018 (95% CI 50.8-65.2), whereas mortality rates in the general population significantly declined over time. The annual SMRs for GCA patients generally increased over time, with the lowest SMR occurring in 2002 (1.22 [95% CI 1.03-1.40]) and the highest in 2018 (1.92 [95% CI 1.81-2.03]). GCA mortality rates were more elevated for male patients than female patients.
Over a 19-year period, mortality rates were increased among GCA patients relative to the general population, and more premature deaths were occurring in younger age groups. The relative excess mortality for GCA patients did not improve over time.
关于巨细胞动脉炎（GCA）患者死亡率的报告结果不一。我们的目的是随着时间的推移，评估 GCA 患者与普通人群相比的全因死亡率。
我们在加拿大安大略省进行了一项基于人群的研究，使用健康管理数据。我们研究了一个年龄≥50 岁的 GCA 患者队列，该队列是使用经过验证的病例定义确定的（阳性预测值 81%，特异性 100%）。普通人群对照者为年龄≥50 岁且无 GCA 的居民。死亡从生命统计数据中确定。2000 年至 2018 年，确定了有无 GCA 的个体的每年粗死亡率、年龄和性别标准化死亡率以及年龄和性别特异性全因死亡率。计算了标准化死亡率比（SMR）。
与对照者相比，GCA 患者的年龄和性别标准化死亡率明显更高，且随着时间的推移呈上升趋势，2000 年每 1000 例 GCA 患者中有 50.0 例死亡（95%置信区间 [95%CI] 34.0-71.1），2018 年每 1000 例 GCA 患者中有 57.6 例死亡（95%CI 50.8-65.2），而普通人群的死亡率随着时间的推移显著下降。GCA 患者的年 SMR 通常随着时间的推移而增加，2002 年的 SMR 最低（1.22 [95%CI 1.03-1.40]），2018 年的 SMR 最高（1.92 [95%CI 1.81-2.03]）。GCA 死亡率在男性患者中高于女性患者。
在 19 年期间，GCA 患者的死亡率相对于普通人群有所增加，并且更年轻的年龄组发生了更多的过早死亡。GCA 患者的相对超额死亡率并未随着时间的推移而改善。
