From: Risk factors for Lyme disease stage and manifestation using electronic health records
Characteristic | Early Lyme disease | Disseminated Lyme disease | Disseminated manifestations | ||||
---|---|---|---|---|---|---|---|
Arthritis | Neurological manifestations | Carditis | Secondary erythema migrans | Other disseminated manifestations | |||
n = 3151 | n = 1379 | n = 762 | n = 426 | n = 76 | n = 95 | n = 76 | |
Sex, female, n (%) | 1426 (45.3%) | 618 (44.8%) | 346 (45.4%) | 194 (45.5%) | 21 (27.6%) | 47 (49.5%) | 40 (52.6%) |
Age, years, median (IQR) | 40.7 (12.9, 59.8) | 31.5 (10.8, 57.3) | 28.6 (9.8, 57.2) | 37.8 (14.9, 57.2) | 39.1 (20.7, 58.9) | 17.9 (7.5, 57.4) | 17.5 (8.7, 53.4) |
Age, n (%) | |||||||
 < 10 years | 627 (19.9%) | 311 (22.6%) | 196 (25.7%) | 66 (15.5%) | 3 (4.0%) | 32 (33.7%) | 25 (32.9%) |
 10 to < 20 years | 384 (12.2%) | 261 (18.9%) | 141 (18.5%) | 77 (18.1%) | 15 (19.7%) | 18 (18.9%) | 16 (21.1%) |
 20 to < 30 years | 244 (7.7%) | 100 (7.3%) | 51 (6.7%) | 35 (8.2%) | 13 (17.1%) | 7 (7.4%) | 1 (1.3%) |
 30 to < 50 years | 642 (20.4%) | 249 (18.1%) | 118 (15.5%) | 101 (23.7%) | 18 (23.7%) | 8 (8.4%) | 13 (17.1%) |
 50 to < 70 years | 952 (30.2%) | 333 (24.2%) | 188 (24.7%) | 110 (25.8%) | 19 (25.0%) | 20 (21.1%) | 15 (19.7%) |
 > 70 years | 302 (9.6%) | 125 (9.1%) | 68 (8.9%) | 37 (8.7%) | 8 (10.5%) | 10 (10.5%) | 6 (7.9%) |
Race/ethnicity, non-White, n (%)a | 34 (1.1%) | 25 (1.8%) | 14 (1.8%) | 8 (1.9%) | 0 (0%) | 1 (1.1%) | 3 (3.9%) |
Year of diagnosis, n (%) | |||||||
 2012 | 322 (10.2%) | 234 (17.0%) | 163 (21.4%) | 51 (12.0%) | 6 (7.9%) | 12 (12.6%) | 9 (11.8%) |
 2013 | 527 (16.7%) | 235 (17.0%) | 134 (17.6%) | 78 (18.3%) | 17 (22.4%) | 8 (8.4%) | 9 (11.8%) |
 2014 | 607 (19.3%) | 278 (20.2%) | 149 (19.6%) | 89 (20.1%) | 19 (25%) | 24 (25.3%) | 10 (13.2%) |
 2015 | 765 (24.3%) | 278 (20.2%) | 145 (19.0%) | 96 (22.5%) | 11 (14.5%) | 20 (21.1%) | 15 (19.7%) |
 2016 | 90 (29.5%) | 354 (25.7%) | 171 (22.4%) | 112 (26.3%) | 23 (30.3%) | 31 (32.6%) | 33 (43.4%) |
Season of diagnosis, n (%) | |||||||
 Winter (Dec–Feb) | 109 (3.5%) | 181 (13.1%) | 145 (19.0%) | 30 (7.0%) | 2 (2.6%) | 4 (4.2%) | 5 (6.6%) |
 Spring (March–May) | 356 (11.3%) | 181 (13.1%) | 140 (18.4%) | 36 (8.5%) | 4 (5.2%) | 8 (8.4%) | 3 (3.9%) |
 Summer (June–Aug) | 2110 (67.0%) | 653 (47.4%) | 222 (29.1%) | 289 (67.8%) | 54 (71.1%) | 69 (72.6%) | 52 (68.4%) |
 Fall (Sept–Nov) | 576 (18.3%) | 364 (26.4%) | 255 (33.5%) | 71 (16.7%) | 16 (21.1%) | 14 (14.7%) | 16 (21.1%) |
Setting of diagnosis, n (%) | |||||||
 Outpatient | 2312 (73.4%) | 1110 (80.5%) | 667 (87.5%) | 310 (72.8%) | 33 (43.4%) | 80 (84.2%) | 66 (86.8%) |
 Urgent care | 667 (21.5%) | 56 (4.1%) | 32 (4.2%) | 13 (3.1%) | 0 (0%) | 11 (11.6%) | 1 (1.3%) |
 Emergency | 131 (4.2%) | 77 (5.6%) | 28 (3.7%) | 39 (9.2%) | 4 (5.3%) | 4 (4.2%) | 3 (3.9%) |
 Inpatient | 31 (1.0%) | 136 (9.9%) | 35 (4.6%) | 64 (15.0%) | 39 (51.3%) | 0 (0.0%) | 6 (7.9%) |
Primary care contact, yes, n (%) | 2619 (83.1%) | 948 (68.8%) | 540 (70.9%) | 287 (67.4%) | 43 (56.6%) | 80 (84.2%) | 38 (50.0%) |
Medical assistance, n (%) | |||||||
 0% time | 2554 (81.1%) | 1061 (76.9%) | 571 (74.9%) | 336 (78.9%) | 60 (78.9%) | 76 (80.0%) | 59 (77.6%) |
 > 0% to < 50% time | 370 (11.7%) | 156 (11.3%) | 83 (10.9%) | 45 (10.6%) | 8 (10.5%) | 13 (13.7%) | 16 (21.1%) |
 ≥ 50% time | 227 (7.2%) | 162 (11.7%) | 108 (14.2%) | 45 (10.6%) | 8 (10.5%) | 6 (6.3%) | 1 (1.3%) |
Community of residence, n (%) | |||||||
 Township | 2424 (76.9%) | 1002 (72.7%) | 564 (74.0%) | 299 (70.2%) | 50 (65.8%) | 72 (75.8%) | 55 (72.4%) |
 Borough | 613 (19.5%) | 309 (22.4%) | 163 (21.4%) | 97 (22.8%) | 24 (31.6%) | 22 (23.2%) | 19 (25.0%) |
 City | 114 (3.6%) | 68 (4.9%) | 35 (4.6%) | 30 (7.0%) | 2 (2.6%) | 1 (1.1%) | 2 (2.6%) |
Urban/rural residence, n (%) | |||||||
 Rural | 1987 (63.1%) | 820 (59.5%) | 459 (60.2%) | 251 (58.9%) | 44 (57.9%) | 57 (60.0%) | 45 (59.2%) |
 Urban cluster | 465 (14.8%) | 239 (17.3%) | 134 (17.6%) | 76 (17.8%) | 12 (15.8%) | 19 (20.0%) | 19 (25.0%) |
 Urbanized area | 699 (22.2%) | 320 (23.2%) | 169 (22.2%) | 99 (23.2%) | 20 (26.3%) | 19 (20.0%) | 12 (15.8%) |
Community socioeconomic deprivation, n (%) | |||||||
 Quartile 1 | 918 (29.1%) | 355 (25.7%) | 198 (26.0%) | 103 (24.2%) | 26 (34.2%) | 25 (26.3%) | 18 (23.7%) |
 Quartile 2 | 1031 (32.7%) | 423 (30.7%) | 234 (30.7%) | 125 (29.3%) | 20 (26.3%) | 38 (40.0%) | 26 (34.2%) |
 Quartile 3 | 746 (23.7%) | 370 (26.8%) | 201 (26.4%) | 119 (27.9%) | 17 (22.4%) | 17 (17.9%) | 23 (30.3%) |
 Quartile 4 | 456 (14.5%) | 231 (16.8%) | 129 (16.9%) | 79 (18.5%) | 13 (17.1%) | 15 (15.8%) | 9 (11.8%) |
Antibiotic order within ± 30 days, n (%)c | 2977 (94.5%) | 1135 (82.3%) | 618 (81.1%) | 349 (81.9%) | 64 (84.2%) | 88 (92.6%) | 59 (77.6%) |
Lyme disease serology order ± 30 days, n (%) | –b | 810 (58.7%) | 468 (61.4%) | 240 (56.3%) | 36 (47.4%) | 42 (44.2%) | 34 (44.7%) |
IgG+ WB or EIA+/IgM+ WB ± 30 days, n (%) | –b | 621 (45.0%) | 333 (43.7%) | 202 (47.4%) | 49 (64.5%) | 30 (31.6%) | 29 (38.2%) |