Suellen Anne Lyne, Susan Lester, Oscar Kenneth Russell, Carlee Deanne, Kathryn Dyer, Jem Ninan, Ernst Michael Shanahan, Catherine Louise Hill
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引用次数: 0
Abstract
Background: Data regarding the relationship between socioeconomic status (SES) and incidence of Giant Cell Arteritis (GCA) is conflicting. No previous studies have explored whether SES influences the likelihood of undergoing temporal artery biopsy (TAB). The aim of this study was to determine whether SES influences access to TAB and rate of biopsy positivity in those with suspected GCA.
Methods: This retrospective study included consecutive patients who underwent TAB examined at SA Pathology between 2017 and 2022; age ≥ 50 years and resident in South Australia (SA). Patients' addresses were used to identify precise geographical areas. Area-level SES was determined using Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) scores, derived from 2016 Census data. IRSAD scores were grouped into population quintiles and analysed by multinomial regression.
Results: 626 participants were included, of whom 155 (25%) were TAB positive. Those with positive TAB were older (76 v 72 years) and a smaller proportion were female (63% v 71%). There was a shift towards a lower SES for patients undergoing TAB, with 161 (26%) in the lowest quintile and 107 (17%) in the highest (plinear<0.001). However, SES was not associated with TAB positivity; 34/161 (21%) participants were TAB positive in the lowest quintile compared to 33/107 (31%) in the highest (p = 0.19).
Conclusion: SES did not influence incidence of GCA. However, those from lower SES population quintiles were more likely to undergo TAB at a State Pathology service provider. Encouragingly, this suggests there is no issue with access to TAB in SA based on SES.
背景:关于社会经济地位(SES)与巨细胞动脉炎(GCA)发病率之间关系的数据是相互矛盾的。以前没有研究探讨SES是否影响接受颞动脉活检(TAB)的可能性。本研究的目的是确定SES是否会影响疑似GCA患者获得TAB和活检阳性率。方法:本回顾性研究纳入了2017年至2022年间在SA病理学中接受TAB检查的连续患者;年龄≥50岁,居住在南澳大利亚州。病人的地址被用来确定精确的地理区域。根据2016年人口普查数据得出的相对社会经济优势和劣势指数(IRSAD)得分来确定区域级SES。IRSAD评分按人口五分位数分组,采用多项回归分析。结果:纳入626例受试者,其中TAB阳性155例(25%)。TAB阳性者年龄较大(76 vs 72岁),女性比例较小(63% vs 71%)。接受TAB治疗的患者有较低社会地位的转变,最低五分位数为161人(26%),最高五分位数为107人(17%)。然而,那些来自较低社会经济地位人群五分之一的人更有可能在国家病理服务提供商接受TAB。令人鼓舞的是,这表明在基于SES的SA中访问TAB没有问题。