Objective Racial and ethnic differences in presentation and outcomes have been reported in systemic sclerosis (SSc) and SSc-interstitial lung disease (ILD). However, prior studies have limited diversity. We aim to evaluate if there are racial/ethnic differences associated with ILD, time intervals between SSc and ILD and with emergency department (ED) visit or hospitalization rates. Methods Clinical and sociodemographic variables were extracted for 756 patients with SSc from longitudinal health records in an integrated health-system. Logistic regression models analyzed the association of covariates with ILD and age at SSc-ILD. Healthcare outcomes were analyzed with complementary log-log regression models. Results Overall, 33.7% of patients in the cohort had an ILD code, with increased odds for Asian (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.29–5.28; p=0.008) compared with White patients. The predicted age in years of SSc-ILD was younger for Hispanic (estimate, -6.5; 95% CI, -13—-0.21; p = 0.04) and Black/African American patients (-10; 95% CI -16—-4.9; p < 0.001) compared with White patients. Black/African American patients were more likely to have an ILD code before an SSc code (59% compared with 20.6% of White patients), and the shortest interval from SSc to ILD (3 months). Black/African American (HR, 2.59; 95% CI 1.47–4.49; p = 0.001) and Hispanic patients (HR 2.29; 95% CI 1.37– 3.82; p = 0.002) had higher rates of an ED visit. Conclusion We found that odds of SSc-ILD differed by racial/ethnic group, minoritized patients had earlier age of presentation, and greater rates of an ED visit.

中文翻译：

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种族和民族与间质性肺病和系统性硬化症患者医疗保健利用的关系


目的 系统性硬化症 (SSc) 和 SSc 间质性肺病 (ILD) 的表现和结果存在种族和民族差异。然而，先前的研究多样性有限。我们的目的是评估是否存在与 ILD、SSc 和 ILD 之间的时间间隔以及急诊室 (ED) 就诊或住院率相关的种族/民族差异。方法 从综合卫生系统的纵向健康记录中提取 756 名 SSc 患者的临床和社会人口统计学变量。 Logistic 回归模型分析了协变量与 ILD 和 SSc-ILD 年龄的关联。使用互补的双对数回归模型分析医疗保健结果。结果 总体而言，队列中 33.7% 的患者有 ILD 代码，与白人患者相比，亚裔患者出现 ILD 代码的几率更高（比值比 [OR]，2.60；95% 置信区间 [CI]，1.29–5.28；p=0.008）。西班牙裔患者（估计值，-6.5；95% CI，-13—-0.21；p = 0.04）和黑人/非洲裔美国患者（-10；95% CI -16—-）的 SSc-ILD 预测年龄较年轻（-6.5；95% CI，-13—-0.21；p = 0.04） 4.9；p < 0.001) 与白人患者相比。黑人/非裔美国患者更有可能在 SSc 代码之前先有 ILD 代码（59%，而白人患者为 20.6%），并且从 SSc 到 ILD 的间隔最短（3 个月）。黑人/非裔美国人（HR，2.59；95% CI 1.47–4.49；p = 0.001）和西班牙裔患者（HR 2.29；95% CI 1.37–3.82；p = 0.002）急诊就诊率较高。结论 我们发现 SSc-ILD 的发病率因种族/族裔群体而异，少数患者就诊年龄较早，急诊就诊的比例较高。