过去五十年中，系统性硬化症的死亡率在年轻患者中呈稳步下降趋势。
Steady decrease in systemic sclerosis mortality rates at younger ages over the past five decades.
机构信息
Department of Medicine, University of California at Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles, CA, USA.
Johns Hopkins Whiting School of Engineering, Baltimore, MD, USA.
出版信息
Rheumatology (Oxford). 2024 Feb 1;63(2):466-471. doi: 10.1093/rheumatology/kead233.
OBJECTIVE
We aimed to assess SSc mortality by age in the general population over the past five decades.
METHODS
This is a population-based study using a national mortality database and the census data for all US residents. We calculated the proportions of deaths for SSc and for all other causes (non-SSc) by age, and calculated age-standardized mortality rates (ASMRs) for SSc and non-SSc, and the ratio of SSc-ASMR to non-SSc-ASMR by age groups for each year from 1968 through 2015. We performed joinpoint regression to estimate the average annual percent change (AAPC) for each of these parameters.
RESULTS
SSc was recorded as the underlying cause of death in 5457 decedents aged ≤44 years, 18 395 aged 45-64, and 22 946 aged ≥65 from 1968 through 2015. At ages ≤44, the proportion of annual deaths decreased more for SSc than for non-SSc: AAPC, -2.2% (95% CI, -2.4% to -2.0%) for SSc vs -1.5% (-1.9% to -1.1%) for non-SSc. Consistently, SSc-ASMR decreased from 1.0 (95% CI, 0.8-1.2) in 1968 to 0.4 (0.3-0.5) per million persons in 2015, a cumulative decrease of 60% at an AAPC of -1.9% (95% CI, -2.5% to -1.2%) at ages ≤44. The SSc-ASMR:non-SSc-ASMR ratio also decreased [cumulative -20%; AAPC -0.3% (95% CI, -1.15% to 0.55%)] in the ≤44-years group. In contrast, those aged ≥65 experienced a steep increase in the SSc-ASMR [cumulative 187.0%; AAPC 2.0% (95% CI, 1.8-2.2)] and the SSc-ASMR:non-SSc-ASMR ratio [cumulative 395.4%; AAPC 3.3% (95% CI, 2.9-3.7)].
CONCLUSION
Mortality for SSc has steadily decreased at younger ages over the past five decades.
目的
评估过去五十年间普通人群中 SSc 的年龄相关死亡率。
方法
本研究采用全国死亡率数据库和美国所有居民的人口普查数据，开展基于人群的研究。我们按年龄计算 SSc 和所有其他原因（非 SSc）的死亡比例，并计算 SSc 和非 SSc 的年龄标准化死亡率（ASMR），以及 1968 年至 2015 年每年各年龄组的 SSc-ASMR 与非 SSc-ASMR 比值。我们采用连接点回归估计这些参数的年均百分比变化（AAPC）。
结果
1968 年至 2015 年，5457 名≤44 岁、18395 名 45-64 岁和 22946 名≥65 岁的死者中，SSc 被记录为根本死因。在≤44 岁年龄组，SSc 的年死亡比例降幅大于非 SSc：SSc 的 AAPC 为-2.2%（95%CI：-2.4%至-2.0%），而非 SSc 为-1.5%（95%CI：-1.9%至-1.1%）。同样，SSc-ASMR 从 1968 年的 1.0（95%CI：0.8-1.2）降至 2015 年的 0.4（0.3-0.5）/百万人，累计降幅为 60%，在≤44 岁年龄组的 AAPC 为-1.9%（95%CI：-2.5%至-1.2%）。SSc-ASMR 与非 SSc-ASMR 比值也呈下降趋势[累计下降 20%；AAPC 为-0.3%（95%CI：-1.15%至 0.55%）]。相比之下，≥65 岁年龄组的 SSc-ASMR 急剧增加[累计增加 187.0%；AAPC 为 2.0%（95%CI：1.8-2.2）]，SSc-ASMR 与非 SSc-ASMR 比值也急剧增加[累计增加 395.4%；AAPC 为 3.3%（95%CI：2.9-3.7）]。
结论
过去五十年间，SSc 的死亡率在年轻人群中持续下降。
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