Abstract
Background Disease burden is the impact of a health problem on a given area, which can be used to prioritize actions in health, assess performance of healthcare and disease management, identify high-risk populations, and set research priorities. Disease burden can be measured using a variety of indicators such as mortality, morbidity or financial cost. For SLE, despite a relatively good 10 year survival (95%, vs 97% in controls), its mortality rate remains high relative to general population mortality rate as shown in our analysis of the Centers for Disease Control (CDC)’s mortality database comprising of 62,843 SLE deaths. However, mortality rates may not adequately measure SLE burden, because among those who died, a fifth of patients died before reaching 40 years of age. Premature mortality, a measure of burden first proposed in 1940s to address the inadequacy of mortality in measuring the burden of tuberculosis, is an important way to quantify disease burden. In constructing a measure of premature death, an arbitrary limit to life is chosen, and the calculation of the difference between an age at death and this arbitrary limit is defined as the life lost as a result of that death. To assess the relative burden of SLE, we measured the years of potential life lost (YPLL) for SLE relative to CDC’s top 15 leading causes of death.
Methods This is a population-based study. Death counts were obtained from the CDC-WONDER database. Number of deaths were tabulated for top 15 CDC’s leading causes-of-death and SLE. To calculate YPLL, each decedent’s age at death from a specific disease was subtracted from a predetermined age of 75 years. The years of potential life lost were then added together to yield the total YPLL.
Results 28 411 female SLE deaths were recorded during 2000–2015. The ranking of SLE deaths relative to the CDC’s official leading-causes-of-death ranklist in females showed that SLE is within the top 15 leading causes-of-death in reproductive age women (15–44 years) and tenth among women ages 15–24 years. We calculated YPLL for SLE relative to the CDC’s official 15 leading causes-of-death in women ages 15–44 and 15–24. YPLL for SLE ranked 14th in women ages 15–44, and 8th in women ages 15–24, above diabetes mellitus, HIV disease, septicemia, chronic lower respiratory disease, anemias, nephritis, and cerebrovascular disease.
Conclusions SLE is among the leading cause of YPLL in young women, underscoring SLE as an important public health issue.
