High mortality in North American Natives with systemic lupus erythematosus
Notice bibliographique
Résumé
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. A total of 807 patients with SLE were identified: 201 (25%) patients were NAI, 501 (62%) were Caucasian, and the remaining 105 (13%) were OEM. NAI and OEM patients were younger at diagnosis (NAI = 32 ± 15 years; OEM = 31 ± 14 years; Caucasian = 37 ± 15 years; P = 0.001), had a shorter disease duration (NAI = 11 ± 9 years; OEM = 10 ± 9 years; Caucasian = 15 ± 11 years; P = 0.001) and had more frequent nephritis (NAI = 41%; OEM = 49%; Caucasian = 29%; P = 0.001) compared with Caucasians. More NAI had died by the end of the follow-up period (NAI = 25%; OEM = 7%; Caucasian = 18%; P < 0.001) and mean age at death was much younger in both NAI and OEM (NAI = 50 ± 16 years; OEM = 46 ± 14 years; Caucasian = 63 ± 16 years; P = 0.001). Survival rates were significantly worse in NAI compared with OEM and Caucasians (Figure 1 ): 10-year survival 85% versus 97% and 92%; 15-year survival 75% versus 89% and 88% respectively ( P < 0.001). In a Cox proportional hazards model, the risk of death following diagnosis was higher for NAI (hazard ratio 2.5; 95% CI: 1.6 to 3.9) after adjustment for onset age, damage, and lupus manifestations. Kaplan-Meier survival curve . 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.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».