PDF(Pubmed)
Abstract：
UNASSIGNED: Classification of thyroid eye disease (TED) is largely based on guidelines developed in Europe and North America. Few studies have investigated the presentation and treatment of TED in Black populations. The objective is to examine the manifestations of TED in secondary and tertiary care center-based populations with a significant proportion of Black patients.
UNASSIGNED: Retrospective chart review identifying patients with a reported race/ethnicity and a presenting clinical diagnosis of TED at Kings County Hospital and SUNY Downstate Medical Center and affiliated clinics from January 1, 2010 through July 31, 2021. Main outcome measures include age of disease onset, sex, smoking status, insurance status, postal code of residence, clinical exam features, number of follow-up visits, length of follow-up, and treatments received.
UNASSIGNED: Of the 80 patients analyzed, 49 were Black (61.2%) and 31 were White (38.8%). Between Black and White patients, there were differences in the mean age of presentation (48.1 [range 21-76] vs 56.8 [range 28-87] years, P=0.03), insurance status (51.0% vs 77.4% private insurance, P=0.02), and mean follow up length among those with multiple visits (21.6 [range 2-88] vs 9.7 [range 1-48] months, P=0.02). The distribution of EUGOGO scores were not significantly different between Black and White patients. On initial presentation, fewer Black patients had chemosis (OR 0.21, 95% CI, 0.08 to 0.57, P=0.002), and caruncular swelling (OR 0.19, 95% CI, 0.06 to 0.59, P=0.002) compared to White patients. During the overall disease course, fewer Black patients had subjective diplopia (OR 0.20, 95% CI, 0.07 to 0.56, P=0.002), chemosis (OR 0.24, 95% CI, 0.09 to 0.63, P=0.004), and caruncular swelling (OR 0.18, 95% CI, 0.07 to 0.51, P=0.001) compared to White patients. Black patients received oral steroids (42.9% vs 67.7%, P=0.03), intravenous steroids (18.4% vs 16.1%, P=0.8), orbital decompression surgery (16.7% vs 6.5%, P=0.19), and teprotumumab (22.9% vs 22.6%, P=0.99) at similar rates.
UNASSIGNED: Black patients presented with fewer external exam findings suggestive of active TED compared to White patients, but the rate of compressive optic neuropathy and decompression surgery were similar in the two groups. These differences may be due to disease phenotypes, which warrant further study.
UNASSIGNED: Retrospective chart review identifying patients with a reported race/ethnicity and a presenting clinical diagnosis of TED at Kings County Hospital and SUNY Downstate Medical Center and affiliated clinics from January 1, 2010 through July 31, 2021. Main outcome measures include age of disease onset, sex, smoking status, insurance status, postal code of residence, clinical exam features, number of follow-up visits, length of follow-up, and treatments received.
UNASSIGNED: Of the 80 patients analyzed, 49 were Black (61.2%) and 31 were White (38.8%). Between Black and White patients, there were differences in the mean age of presentation (48.1 [range 21-76] vs 56.8 [range 28-87] years, P=0.03), insurance status (51.0% vs 77.4% private insurance, P=0.02), and mean follow up length among those with multiple visits (21.6 [range 2-88] vs 9.7 [range 1-48] months, P=0.02). The distribution of EUGOGO scores were not significantly different between Black and White patients. On initial presentation, fewer Black patients had chemosis (OR 0.21, 95% CI, 0.08 to 0.57, P=0.002), and caruncular swelling (OR 0.19, 95% CI, 0.06 to 0.59, P=0.002) compared to White patients. During the overall disease course, fewer Black patients had subjective diplopia (OR 0.20, 95% CI, 0.07 to 0.56, P=0.002), chemosis (OR 0.24, 95% CI, 0.09 to 0.63, P=0.004), and caruncular swelling (OR 0.18, 95% CI, 0.07 to 0.51, P=0.001) compared to White patients. Black patients received oral steroids (42.9% vs 67.7%, P=0.03), intravenous steroids (18.4% vs 16.1%, P=0.8), orbital decompression surgery (16.7% vs 6.5%, P=0.19), and teprotumumab (22.9% vs 22.6%, P=0.99) at similar rates.
UNASSIGNED: Black patients presented with fewer external exam findings suggestive of active TED compared to White patients, but the rate of compressive optic neuropathy and decompression surgery were similar in the two groups. These differences may be due to disease phenotypes, which warrant further study.
摘要：
■甲状腺眼病（TED）的分类主要基于欧洲和北美制定的指南。很少有研究调查TED在黑人人群中的表现和治疗。目的是检查TED在以二级和三级护理中心为基础的人群中的表现，其中黑人患者占很大比例。
■回顾性图表审查，从2010年1月1日至2021年7月31日，在金斯县医院和纽约州立大学下州医疗中心及其附属诊所确定报告有种族/民族和TED临床诊断的患者。主要结局指标包括发病年龄，性别,吸烟状况,保险状况,住宅邮政编码,临床检查特征，随访次数,随访时间，和接受的治疗。
■在分析的80例患者中，49人为黑色（61.2%），31人为白色（38.8%）。在黑人和白人患者之间，呈现的平均年龄存在差异（48.1[范围21-76]vs56.8[范围28-87]岁，P=0.03),保险状况(51.0%对77.4%的私人保险，P=0.02),多次访问者的平均随访时间（21.6[范围2-88]vs9.7[范围1-48]个月，P=0.02)。EUGOGO评分的分布在黑人和白人患者之间没有显着差异。在最初的介绍中，较少的Black患者发生化学性病变（OR0.21，95%CI，0.08至0.57，P=0.002），与白人患者相比（OR0.19，95％CI，0.06至0.59，P=0.002）。在整个疾病过程中，黑人患者主观复视较少(OR0.20,95%CI,0.07~0.56,P=0.002),化学（OR0.24，95％CI，0.09至0.63，P=0.004），与白人患者相比（OR0.18，95％CI，0.07至0.51，P=0.001）。黑人患者接受口服类固醇（42.9%vs67.7%，P=0.03),静脉注射类固醇（18.4%vs16.1%，P=0.8),眼眶减压手术(16.7%vs6.5%，P=0.19),和teprotumumab（22.9%vs22.6%，P=0.99），比率相似。
■与白人患者相比，黑人患者的外部检查结果较少，提示TED活跃，但是两组的压迫性视神经病变和减压手术的发生率相似。这些差异可能是由于疾病表型，这需要进一步研究。
■回顾性图表审查，从2010年1月1日至2021年7月31日，在金斯县医院和纽约州立大学下州医疗中心及其附属诊所确定报告有种族/民族和TED临床诊断的患者。主要结局指标包括发病年龄，性别,吸烟状况,保险状况,住宅邮政编码,临床检查特征，随访次数,随访时间，和接受的治疗。
■在分析的80例患者中，49人为黑色（61.2%），31人为白色（38.8%）。在黑人和白人患者之间，呈现的平均年龄存在差异（48.1[范围21-76]vs56.8[范围28-87]岁，P=0.03),保险状况(51.0%对77.4%的私人保险，P=0.02),多次访问者的平均随访时间（21.6[范围2-88]vs9.7[范围1-48]个月，P=0.02)。EUGOGO评分的分布在黑人和白人患者之间没有显着差异。在最初的介绍中，较少的Black患者发生化学性病变（OR0.21，95%CI，0.08至0.57，P=0.002），与白人患者相比（OR0.19，95％CI，0.06至0.59，P=0.002）。在整个疾病过程中，黑人患者主观复视较少(OR0.20,95%CI,0.07~0.56,P=0.002),化学（OR0.24，95％CI，0.09至0.63，P=0.004），与白人患者相比（OR0.18，95％CI，0.07至0.51，P=0.001）。黑人患者接受口服类固醇（42.9%vs67.7%，P=0.03),静脉注射类固醇（18.4%vs16.1%，P=0.8),眼眶减压手术(16.7%vs6.5%，P=0.19),和teprotumumab（22.9%vs22.6%，P=0.99），比率相似。
■与白人患者相比，黑人患者的外部检查结果较少，提示TED活跃，但是两组的压迫性视神经病变和减压手术的发生率相似。这些差异可能是由于疾病表型，这需要进一步研究。
