Abstract
Background Disease burden is the impact of a health problem on a given area, which can be used to set healthcare and research priorities and identify high-risk populations. Disease burden can be measured using a variety of indicators such as mortality, morbidity, disability, or financial cost. Analyses of 62,843 SLE deaths from the US-CDCs database showed that SLE-mortality remains high relative to general population mortality (Yen E, et al. Ann Int Med 2017). However, mortality rates may not adequately measure SLE burden, because among those who died, a fifth died before reaching 40 years. Premature mortality is an important way to quantify disease burden. In constructing a measure of premature death, an arbitrary limit to life is chosen, and the years of potential life lost (YPLL) is calculated.
Methods This is a population-based observational study. Death counts were obtained from the CDC-WONDER for 28 diseases, including SLE, top 15 CDCs leading causes-of-death, and 12 other autoimmune diseases. To calculate YPLL, each decedents 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 From 2000 through 2015, SLE was recorded as the cause of death in 28 411 women in the US. The ranking of SLE deaths relative to the CDCs official leading-causes-of-death 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. YPLL for SLE was 304.2 thousand years in women ages 15–44 and 66.2 thousand years in women ages 15–24. SLE-YPLL ranked #14 in women ages 15–44, and #8 in women ages 15–24 above diabetes mellitus, HIV disease, septicemia, chronic lower respiratory disease, anemias, nephritis, and cerebrovascular disease. However, the NIH research funding for SLE is not commensurate with its relative premature mortality burden: NIH provided $97 million for SLE research in comparison to $1,084 million for diabetes mellitus and $3,780 million for HIV in 2016. Among autoimmune diseases, SLE ranked #2 in women ages 15–44 years and #1 in women ages 15–24 years.
Conclusions SLE is among the leading causes of premature mortality burden in young women, underscoring SLE as an important public health issue. This warrants further studies on SLE disease burden, which can be used to develop and prioritize public health programs, assess performance of changes in SLE management, identify high-risk populations, and set research priorities and funding.
Funding Source(s): None
