title: Systemic sclerosis mortality in the United States: 1999-2002 implications for patient care.
abstract: OBJECTIVE
  To describe the systemic sclerosis mortality rates in the United States between 1999 and 2002, a time period in which a new coding system was used to record deaths, and to describe its implications in patient care.
  
  
  METHODS
  We used the mortality database from the National Center of Health Statistics and with the use of ICD-10 codes for systemic sclerosis calculated death rates by gender, race, age, state, and region for the United States. Death rates are expressed as per million population.
  
  
  RESULTS
  Age-adjusted death rates for systemic sclerosis were 6.8 cases per million in women, 2.1 cases per million in men, and 4.7 cases per million for the whole population. Death rates peaked a decade earlier in the African American population when compared with those in the white population (65-74 vs. 75-84 years of age). Age-adjusted mortality was highest in African American women at 9.5 cases per million.
  
  
  CONCLUSIONS
  Mortality rates for systemic sclerosis are slightly higher since the implementation of the new disease-specific ICD-10 coding system for recording deaths. Death rates related to systemic sclerosis among the African American population are remarkably higher than those among the white population; this is believed to be related to the more aggressive disease seen in the African American patients and to the disparity of healthcare resources. These findings suggest that earlier and more aggressive treatment is warranted in the African American population, with more frequent follow-up and preventive care.
authors.affiliation: Division of Rheumatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107-5541, USA.
authors.forename: Fabian
authors.initials: F
authors.lastname: Mendoza
authors.forename: Chris T
authors.initials: CT
authors.lastname: Derk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019992:Databases as Topic; D005260:Female; D005568:Forms and Records Control / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012595:Scleroderma, Systemic / Q000401:mortality*; D014481:United States / Q000453:epidemiology