Racial/Ethnic variation in all-cause mortality among United States medicaid recipients with systemic lupus erythematosus: a Hispanic and asian paradox.

作者: José A. Gómez-Puerta , Medha Barbhaiya , Hongshu Guan , Candace H. Feldman , Graciela S. Alarcón

DOI: 10.1002/ART.38981

关键词: GerontologyDemographyCause of deathYoung adultMedicaidHazard ratioMortality rateIncidence (epidemiology)MedicineLupus erythematosusProportional hazards model

摘要: Objective The incidence of systemic lupus erythematosus (SLE) is disproportionately high in nonwhite patients compared with white patients. However, variation mortality according to race/ethnicity has not been well studied. The aim this study was examine all-cause among SLE enrolled Medicaid. Methods We used Medicaid Analytic eXtract data, billing claims from 47 US states and Washington, DC, identify individuals ages 18–65 years who were for ≥3 months 2000–2006. Individuals classified as having if they had visits ≥30 days apart an International Classification Diseases, Ninth Revision (ICD-9) code (710.0). Among the SLE, those nephritis (LN) identified by presence ≥2 ICD-9 glomerulonephritis, proteinuria, or renal failure. We calculated rates per 1,000 person-years, 95% confidence intervals (95% CIs), race/ethnicity. Multivariable Cox proportional hazards regression models estimate risks, adjusting age, sex, demographics, comorbidities. Results Among 42,221 prevalent cases 8,191 LN identified. Blacks represented 40.1%, whites 38.4%, Hispanics 15.3%. Overall person-years highest Native American (27.52), (20.17), black (24.13) lower Hispanic (7.12) Asian (5.18) After multivariable adjustment, risks (hazard ratio [HR] 0.48 [95% CI 0.40–0.59] 0.59 0.40–0.86], respectively) whites. Conversely, risk death significantly higher (HR 1.40 1.04–1.90]) 1.21 1.10–1.33]) LN, patients. Conclusion After accounting demographic clinical factors, than that black, white,

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