Zeinab Rajabally, Mahmoud A. Mohamed, Lydia Spencer, Niraj Mistry, Yusuf A. Rajabally
{"title":"社会剥夺对慢性炎症性脱髓鞘性多神经病变的诊断、管理和结果的影响","authors":"Zeinab Rajabally, Mahmoud A. Mohamed, Lydia Spencer, Niraj Mistry, Yusuf A. Rajabally","doi":"10.1111/jns.70054","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Whether social deprivation may affect diagnosis, management, and outcomes of subjects with chronic inflammatory demyelinating polyneuropathy (CIDP) is unknown.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We conducted a retrospective study of subjects with CIDP attending University Hospitals Birmingham, UK. Demographics, clinical characteristics, treatment data, post-treatment outcomes and Index of Multiple Deprivation 2019 were collected. Postcodes were categorised in local vs. non-local and travelling distances to the hospital were ascertained.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We included 155 consecutive subjects with CIDP. Mean age was 62.2 years (SD: 15.1). Male to female ratio was 1.67:1. One-hundred and eighteen subjects (76.1%) had typical CIDP. Greater pre-treatment disability was independently associated with greater social deprivation (<i>p</i> = 0.031) and longer pre-treatment disease duration (<i>p</i> = 0.001). Neither use of high-cost first-line therapies, nor immunosuppressant usage, were associated with social deprivation. Post-treatment outcomes were not associated with social deprivation. Greater social deprivation was independently associated with younger age (<i>p</i> = 0.002), having a local post-code (<i>p</i> = 0.001) and living closer to the hospital (<i>p</i> < 0.001). Subjects from the two most socially deprived deciles were younger (<i>p</i> = 0.025) and more disabled pre-treatment (<i>p</i> = 0.028) than those from the two least deprived deciles. Significantly fewer tertiary referrals were received for the two most socially deprived deciles compared to the two least deprived deciles (9.9% vs. 31.3%; <i>p</i> = 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Despite a publicly funded healthcare system with universal access, social deprivation independently contributed to greater pre-treatment disability in subjects with CIDP in this UK cohort. Social deprivation did not impact on treatments administered and post-treatment outcomes but may have influenced tertiary referral decisions to our centre.</p>\n </section>\n </div>","PeriodicalId":17451,"journal":{"name":"Journal of the Peripheral Nervous System","volume":"30 3","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jns.70054","citationCount":"0","resultStr":"{\"title\":\"Impact of Social Deprivation on Diagnosis, Management and Outcome of Chronic Inflammatory Demyelinating Polyneuropathy at a Tertiary UK Centre\",\"authors\":\"Zeinab Rajabally, Mahmoud A. Mohamed, Lydia Spencer, Niraj Mistry, Yusuf A. Rajabally\",\"doi\":\"10.1111/jns.70054\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Whether social deprivation may affect diagnosis, management, and outcomes of subjects with chronic inflammatory demyelinating polyneuropathy (CIDP) is unknown.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We conducted a retrospective study of subjects with CIDP attending University Hospitals Birmingham, UK. Demographics, clinical characteristics, treatment data, post-treatment outcomes and Index of Multiple Deprivation 2019 were collected. Postcodes were categorised in local vs. non-local and travelling distances to the hospital were ascertained.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>We included 155 consecutive subjects with CIDP. Mean age was 62.2 years (SD: 15.1). Male to female ratio was 1.67:1. One-hundred and eighteen subjects (76.1%) had typical CIDP. Greater pre-treatment disability was independently associated with greater social deprivation (<i>p</i> = 0.031) and longer pre-treatment disease duration (<i>p</i> = 0.001). Neither use of high-cost first-line therapies, nor immunosuppressant usage, were associated with social deprivation. Post-treatment outcomes were not associated with social deprivation. Greater social deprivation was independently associated with younger age (<i>p</i> = 0.002), having a local post-code (<i>p</i> = 0.001) and living closer to the hospital (<i>p</i> < 0.001). Subjects from the two most socially deprived deciles were younger (<i>p</i> = 0.025) and more disabled pre-treatment (<i>p</i> = 0.028) than those from the two least deprived deciles. 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Impact of Social Deprivation on Diagnosis, Management and Outcome of Chronic Inflammatory Demyelinating Polyneuropathy at a Tertiary UK Centre
Background
Whether social deprivation may affect diagnosis, management, and outcomes of subjects with chronic inflammatory demyelinating polyneuropathy (CIDP) is unknown.
Methods
We conducted a retrospective study of subjects with CIDP attending University Hospitals Birmingham, UK. Demographics, clinical characteristics, treatment data, post-treatment outcomes and Index of Multiple Deprivation 2019 were collected. Postcodes were categorised in local vs. non-local and travelling distances to the hospital were ascertained.
Results
We included 155 consecutive subjects with CIDP. Mean age was 62.2 years (SD: 15.1). Male to female ratio was 1.67:1. One-hundred and eighteen subjects (76.1%) had typical CIDP. Greater pre-treatment disability was independently associated with greater social deprivation (p = 0.031) and longer pre-treatment disease duration (p = 0.001). Neither use of high-cost first-line therapies, nor immunosuppressant usage, were associated with social deprivation. Post-treatment outcomes were not associated with social deprivation. Greater social deprivation was independently associated with younger age (p = 0.002), having a local post-code (p = 0.001) and living closer to the hospital (p < 0.001). Subjects from the two most socially deprived deciles were younger (p = 0.025) and more disabled pre-treatment (p = 0.028) than those from the two least deprived deciles. Significantly fewer tertiary referrals were received for the two most socially deprived deciles compared to the two least deprived deciles (9.9% vs. 31.3%; p = 0.001).
Conclusions
Despite a publicly funded healthcare system with universal access, social deprivation independently contributed to greater pre-treatment disability in subjects with CIDP in this UK cohort. Social deprivation did not impact on treatments administered and post-treatment outcomes but may have influenced tertiary referral decisions to our centre.
期刊介绍：
The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders.
The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies.
Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials.
The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.
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