In proposing possible explanations for this, Dr. Jorge said it could be because of suboptimal care of comorbidities, such as cardiovascular disease, medication side effects or lack of adequate treatment options for disease control.
Population Trends in Mortality
Ram R. Singh, MD, professor of medicine, Division of Rheumatology, University of California, Los Angeles (UCLA), on behalf of lead author Eric Y. Yen, MD, followed up with another study that looked at the trends in SLE mortality by assessing the temporal trends in and population characteristics associated with mortality for SLE vs. non-SLE causes over 46 years in the U.S.
Data on SLE deaths from death certificates from the Centers for Disease Control and Prevention (CDC) national mortality database was used to calculate the annual percentage change in mortality in the U.S. between 1968 and 2013. To examine the population characteristics associated with SLE mortality, investigators used grouped-data logistic regression to model SLE mortality as a function of these characteristics (i.e., gender, race and geographic region).
The study found that SLE mortality, relative to non-SLE mortality, has not decreased over the 46 years of the study. Compared with a 44% reduction in non-SLE mortality from 1968 to 2013, SLE mortality dropped by 24%.
Using a joinpoint analysis to examine the ratio of SLE and non-SLE mortality rates based on age-standardized mortality rates (ASMRs), the study found that an annual percent reduction of -1.2 in SLE mortality from 1968–1974 was followed by an increase of 6.5% annually from 1975–1980, an increase of 1.4% annually from 1980–1989 and a drop of 1.2% annually from 1999–2013.
When looking at the SLE and non-SLE mortality rates by gender, race and geographic region, the study found that non-SLE mortality continued to decline over the 46-year period regardless of gender, race or geographic region.
The study found, however, that being female, being black and living in the West or South resulted in higher levels of SLE mortality. Highlighted in the study were significant inequities associated with SLE mortality when considering sex, race and geography.
Using national estimates for SLE prevalence per 100,000 to calculate SLE case-fatality based on these variables, the study found men had a higher mortality than women (OR 1.94, P<0.001), the mortality rate of blacks was higher than of other racial groups (OR 5.24, P<0.001), and the mortality rate of people living in the South and West was higher than those living in the Northeast (OR 1.55, P<0.001; and 1.44, P<0.001, respectively).
