High mortality in North American Natives with systemic lupus erythematosus
© Peschken et al.; licensee BioMed Central Ltd. 2014
Published: 18 September 2014
Lupus outcomes including mortality have been found to be worse in most ethnic minorities, but little is known about North American Indigenous people (NAI). We compared mortality in NAI systemic lupus erythematosus (SLE) patients with Caucasian and other ethnic minority (OEM) SLE patients at a single academic center.
Patients were followed from 1990 to 2013 using a custom database. Variables included date of birth, diagnosis, year of disease onset, ethnicity, clinic visit dates, and vital status if known. Records of all patients with a diagnosis of SLE (≥4 American College of Rheumatology criteria) were abstracted. For patients who had not been seen in the last 2 years, updated vital status was obtained from the hospital medical records department. Ethnicity was by self-report, and categorized into NAI, Caucasian and OEM. The age at diagnosis, disease duration and age at last follow-up or age at death was calculated and compared between ethnic groups. Survival time was compared between ethnic groups using Kaplan-Meier and Cox proportional hazard models.
NAI and OEM patients had similarly young onset age and more frequent nephritis, but survival was markedly worse in NAI compared with Caucasians. Urgent improvements in care delivery for NAI with SLE are needed to decrease the significant morbidity and mortality burden from this disease.
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