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美国结节病死亡率的时间趋势变化与差异：1999年至2020年的回顾性分析

Shifting temporal trends and disparities in sarcoidosis mortality in the United States: A retrospective analysis from 1999 to 2020.

作者信息

Raza Fatima Ali, Kumar Sumeet, Mohammad Ayesha, Amin Areej, Ahmad Farooq, Tousif Sohaib, Kamran Urwah, Sahab Lamea Bint, Ali Sajjad, Changez Mah I Kan, Goyal Aman

机构信息

Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan.

Department of Medicine, Dow University of Health Science, Karachi, Pakistan.

出版信息

PLoS One. 2025 Jan 10;20(1):e0317237. doi: 10.1371/journal.pone.0317237. eCollection 2025.

DOI:10.1371/journal.pone.0317237
PMID:39792876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11723600/
Abstract

INTRODUCTION

Sarcoidosis is an inflammatory disease characterized by granulomas, the etiology of which remains unclear. This study examines sarcoidosis-related mortality trends in the United States from 1999 to 2020, with a focus on disparities pertaining to patient sex, geographical location, and urbanization status.

METHODS

We analyzed death certificate data from the CDC WONDER database, using ICD-10 code D86. Age-adjusted mortality rates (AAMR) per 1,000,000 people were calculated. Trends were analyzed using Joinpoint regression models to determine annual percentage changes (APC).

RESULTS

A total of 37,956 Sarcoidosis-related deaths were documented from 1999 to 2020 in the United States. The AAMR increased from 3.9 in 1999 to 6.4 in 2020. Significant mortality increases were observed from 1999-2001 and again from 2018-2020. Mortality rates were consistently higher among women compared to men. A significant difference in AAMR was observed across states, with highest mortality in the South region and lowest in the West region. Urbanization trends shifted from higher AAMR rates in metropolitan to non-metropolitan areas post-2018. Non-Hispanic Black individuals experienced the highest mortality rates throughout the study period.

CONCLUSIONS

This study highlights significant racial and geographic disparities in sarcoidosis-related mortality. Women, Black patients, and those residing in non-metropolitan areas are at the highest risk for Sarcoidosis associated mortality. Targeted public health interventions are required to address these prevalent disparities.

摘要

引言

结节病是一种以肉芽肿为特征的炎症性疾病，其病因尚不清楚。本研究调查了1999年至2020年美国结节病相关的死亡率趋势，重点关注患者性别、地理位置和城市化状况方面的差异。

方法

我们分析了疾病预防控制中心（CDC）WONDER数据库中的死亡证明数据，使用国际疾病分类第十版（ICD - 10）编码D86。计算了每100万人的年龄调整死亡率（AAMR）。使用Joinpoint回归模型分析趋势，以确定年度百分比变化（APC）。

结果

1999年至2020年美国共记录了37956例与结节病相关的死亡。年龄调整死亡率从1999年的3.9上升到2020年的6.4。在1999 - 2001年以及2018 - 2020年观察到死亡率显著上升。女性的死亡率始终高于男性。各州之间年龄调整死亡率存在显著差异，南部地区死亡率最高，西部地区最低。2018年后，城市化趋势从大都市地区较高的年龄调整死亡率转向非大都市地区。在整个研究期间，非西班牙裔黑人的死亡率最高。

结论

本研究突出了结节病相关死亡率方面显著的种族和地理差异。女性、黑人患者以及居住在非大都市地区的人患结节病相关死亡的风险最高。需要有针对性的公共卫生干预措施来解决这些普遍存在的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/124c56468473/pone.0317237.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/d5c7319a0f9e/pone.0317237.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/1ceda7210d4c/pone.0317237.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/837d0f70940b/pone.0317237.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/b9c54129f73a/pone.0317237.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/124c56468473/pone.0317237.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/d5c7319a0f9e/pone.0317237.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/1ceda7210d4c/pone.0317237.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/837d0f70940b/pone.0317237.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/b9c54129f73a/pone.0317237.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fe/11723600/124c56468473/pone.0317237.g005.jpg

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