The Influence of Income and Formal Education on Damage in Brazilian Patients With Systemic Lupus Erythematosus

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dc.contributor.authorde Andrade Teixeira, Roberto Cordeiro
dc.contributor.authorBorba Neto, Eduardo Ferreira
dc.contributor.authorChristopoulos, Georges Basile
dc.contributor.authorSato, Emilia Inoue [UNIFESP]
dc.date.accessioned2019-08-19T11:50:05Z
dc.date.available2019-08-19T11:50:05Z
dc.date.issued2017
dc.description.abstractObjective: The aim of this study was to evaluate the association of socioeconomic status and American College of Rheumatology/Systemic Lupus International Collaborating Clinics Damage Index (SDI) score in Brazilian patients with systemic lupus erythematosus (SLE). Methods: Five hundred twenty-three patients (SLE ACR criteria) 18 years or older who were at 12 months or greater since diagnosis were included. Socioeconomic status was assessed by per-capita income and years of education. Race was categorized as white and nonwhite. The SDI and Mexican SLE Disease Activity Index were used. Statistical Analysis: Mean +/- SD and median were used for descriptive analysis. Student t test, Mann-Whitney U test, chi(2) test, and Spearman rank correlation coefficient and univariate and multivariate regression analyses were performed. The level of significance was set at 5% for all statistical tests. Results: Ninety-six percent were female, 51.2% were nonwhite, and the mean age was 37.8 +/- 1.4 years. Disease duration was 8.2 +/- 10.3 years and formal education was 10.2 +/- 3.5 years. Unemployment among patients was 63.7%, with median monthly per-capita income of US $276. Mean SDI score was 1.4 +/- 1.52, and 65.6% had some type of damage (SDI >= 1). Patients with SDI of 1 or greater had lower income (P = 0.039). Nonwhite patients had higher SDI than did white patients (P = 0.005). The SDI presented a positive correlation with disease duration (P < 0.001) and age (P < 0.001) and a negative correlation with years of education (P = 0.001). Working patients had lower SDI than did inactive ones (P = 0.001). In a multivariate analysis, older age, higher disease duration, nonwhite race, low income, and out-of-work profile were associated with damage. Conclusions: Besides nonmodifiable characteristics such as longer disease duration and older age, low income was also associated with damage. Therefore, interventions to give adequate socioeconomic support are necessary to improve outcome, mainly in poorer and nonwhite SLE patients.en
dc.description.affiliationUniv Estadual Ciencias Saude Alagoas UNCISAL, Dept Internal Med, Maceio Alagoas, Brazil
dc.description.affiliationUniv São Paulo, Dept Internal Med, São Paulo, Brazil
dc.description.affiliationHosp Santa Casa Maceio, Dept Internal Med, Maceio Alagoas, Brazil
dc.description.affiliationUniv Fed São Paulo UNIFESP, Dept Internal Med, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationUnifespUniv Fed São Paulo UNIFESP, Dept Internal Med, Escola Paulista Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent246-251
dc.identifierhttp://dx.doi.org/10.1097/RHU.0000000000000541
dc.identifier.citationJcr-Journal Of Clinical Rheumatology. Philadelphia, v. 23, n. 5, p. 246-251, 2017.
dc.identifier.doi10.1097/RHU.0000000000000541
dc.identifier.issn1076-1608
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/51473
dc.identifier.wosWOS:000406615100002
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjecteducationen
dc.subjectincome and damageen
dc.subjectsocioeconomic factorsen
dc.subjectsystemic lupus erythematosusen
dc.titleThe Influence of Income and Formal Education on Damage in Brazilian Patients With Systemic Lupus Erythematosusen
dc.typeinfo:eu-repo/semantics/article
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