Mortality rates for systemic sclerosis on decline, but still high vs. general population
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Mortality due to systemic sclerosis remains high compared with mortality in the general population, despite a steady decline in mortality rates from 2001 through 2015, according to data published in Arthritis Care & Research.
“The disease-specific mortality rate is an important measure of the burden of disease,” Eric Y. Yen, MD, MS, of UCLA’s David Geffen School of Medicine, and colleagues wrote. “The actual mortality burden of SSc is unknown. Previous studies of SSc mortality were based primarily on deaths in patient cohorts at referral centers, which does not capture changes in incidence over time and does not reflect the actual burden and trends of SSc mortality in the general population. A few studies have used population-based designs but were limited to specific regions, small samples, or relatively short durations.”
To analyze trends in SSc mortality over the past 48 years, Yen and colleagues studied data compiled by the CDC’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) web application, as well as population data from the United States Census Bureau. The researchers calculated agestandardized rates for SSc and nonSSc mortality, as well as the ratio of SScmortality to nonSScmortality for each year from 1968 through 2015.
Yen and colleagues then used a joinpoint regression model to evaluate mortality trends, overall as well as by sex and race.
According to the researchers, there were 46,798 deaths due to SSc, and 106,058,839 nonSSc deaths, from 1968 through 2015. In addition, there were 9,063 deaths with SSc recorded as a contributing cause from 1999 through 2015. Although the nonSSc age-standardized mortality rate decreased throughout the 48-year study period, the SScrelated rate increased from 1968 to 2000. However, the SSc-related mortality rate then declined each year from 2001 through 2015.
The SScrelated age-standardized mortality rate also decreased in cases where SSc was a contributing cause from 1999 to 2015. Women and Black patients demonstrated higher SScrelated mortality rates and SSc-to-nonSSc-mortality-rate ratios than men and white patients, respectively. In addition, SScrelated mortality rates and SScto-nonSScmortality-rate ratios saw higher increases among women and white patients compared with men and Black patients, respectively, during the initial 30 years studied.
“SSc mortality has begun to improve after the year 2000,” Yen and colleagues wrote. “Still, the improvement in SSc mortality has not kept up with an improvement in mortality from other causes in the general population. Comprehensive examination using prospective, population-based data could help clarify the mechanisms of the changing disparities in SSc mortality and identify modifiable risk factors that could be altered to improve outcomes.”
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