Lyne Suellen Anne, Lester Susan, Russell Oscar Kenneth, Deanne Carlee, Dyer Kathryn, Ninan Jem, Shanahan Ernst Michael, Hill Catherine Louise
School of Medicine, The University of Adelaide, North Terrace, Adelaide, 5000, South Australia.
The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, Adelaide, 5011, South Australia.
BMC Rheumatol. 2025 May 14;9(1):52. doi: 10.1186/s41927-025-00503-0.
Data regarding the relationship between socioeconomic status (SES) and incidence of Giant Cell Arteritis (GCA) is conflicting. No previous studies have explored whether SES influences the likelihood of undergoing temporal artery biopsy (TAB). The aim of this study was to determine whether SES influences access to TAB and rate of biopsy positivity in those with suspected GCA.
This retrospective study included consecutive patients who underwent TAB examined at SA Pathology between 2017 and 2022; age ≥ 50 years and resident in South Australia (SA). Patients' addresses were used to identify precise geographical areas. Area-level SES was determined using Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) scores, derived from 2016 Census data. IRSAD scores were grouped into population quintiles and analysed by multinomial regression.
626 participants were included, of whom 155 (25%) were TAB positive. Those with positive TAB were older (76 v 72 years) and a smaller proportion were female (63% v 71%). There was a shift towards a lower SES for patients undergoing TAB, with 161 (26%) in the lowest quintile and 107 (17%) in the highest (p<0.001). However, SES was not associated with TAB positivity; 34/161 (21%) participants were TAB positive in the lowest quintile compared to 33/107 (31%) in the highest (p = 0.19).
SES did not influence incidence of GCA. However, those from lower SES population quintiles were more likely to undergo TAB at a State Pathology service provider. Encouragingly, this suggests there is no issue with access to TAB in SA based on SES.
关于社会经济地位（SES）与巨细胞动脉炎（GCA）发病率之间关系的数据存在矛盾。以前没有研究探讨过SES是否会影响颞动脉活检（TAB）的可能性。本研究的目的是确定SES是否会影响疑似GCA患者接受TAB的机会以及活检阳性率。
这项回顾性研究纳入了2017年至2022年期间在南澳大利亚病理学（SA Pathology）接受TAB检查的连续患者；年龄≥50岁且居住在南澳大利亚（SA）。使用患者地址确定精确的地理区域。区域层面的SES通过相对社会经济优势和劣势指数（IRSAD）得分来确定，该得分源自2016年人口普查数据。IRSAD得分被分为人口五分位数，并通过多项回归进行分析。
纳入了626名参与者，其中155名（25%）TAB呈阳性。TAB呈阳性的患者年龄更大（76岁对72岁），女性比例更低（63%对71%）。接受TAB检查患者的SES有向较低水平转变的趋势，最低五分位数中有161名（26%），最高五分位数中有107名（17%）（p<0.001）。然而，SES与TAB阳性无关；最低五分位数中有34/161（21%）的参与者TAB呈阳性，而最高五分位数中有33/107（31%）（p = 0.19）。
SES不影响GCA的发病率。然而，来自较低SES人口五分位数的人在州病理学服务机构接受TAB检查的可能性更大。令人鼓舞的是，这表明在SA地区，基于SES接受TAB检查不存在问题。
