Session Information
Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: The epidemiology and natural history of sarcoidosis is not well-characterized as only coding-based studies without detailed clinical information from individual medical record review have been reported. This study aimed to assess the predictors of mortality of sarcoidosis, using data from a population-based cohort.
Methods: An inception cohort of patients who were diagnosed with sarcoidosis in 1976-2013 in a geographically well-defined population was identified based on comprehensive individual medical record review. Diagnosis required histopathological confirmation and diagnostic radiologic features of intrathoracic sarcoidosis, compatible clinical presentation, and exclusion of other known causes of granulomatous inflammation. Histopathological confirmation required presence of non-caseating granuloma without evidence of acid-fast bacilli or fungi. The only exception to the requirement of histopathological confirmation was stage I pulmonary sarcoidosis that required only radiographic evidence of symmetric bilateral hilar adenopathy with or without mediastinal lymphadenopathy. Cases of isolated granulomatous disease of the skin without other features of sarcoidosis were not included. Data were collected on demographic, clinical presentation, laboratory investigations and mortality. Univariable Cox models were used to identify prognostic factors of death.
Results: In 1976-2013, 345 incident cases of sarcoidosis were identified. 50.4% of the cohort was female and the mean age of the cohort was 45.6 years. During follow-up (median: 12.2 years; 5002 total person-years), 50 patients died.
Age, male sex, absence of intra-thoracic disease, and hepatic, cardiac, splenic or neurological involvement in conjunction with intra-thoracic disease were predictive factors for mortality in univariable models after adjustment for age, sex and calendar year of sarcoidosis diagnosis (Table 1).
Conclusion: Age, male sex, absence of intra-thoracic disease, and hepatic, cardiac, splenic or neurological involvement in conjunction with intra-thoracic disease were prognostic factors associated with mortality in patients with sarcoidosis.
Table 1: Predictors of mortality among patients with sarcoidosis
|
Characteristic |
Hazard ratio* (95% CI) |
p-value |
|
Age, per 10 year increase |
2.48 (1.97, 3.13) |
<0.001 |
|
Male sex |
1.98 (1.04, 3.79) |
0.038 |
|
Calendar year of diagnosis, per 1 year increase |
0.98 (0.94, 1.02) |
0.25 |
|
Black (vs white ethnicity) |
3.16 (0.72, 13.81) |
0.29 |
|
Other (vs white ethnicity) |
1.33 (0.32, 5.58) |
|
|
Former smoker (vs never) |
1.80 (0.76, 4.30) |
0.36 |
|
Current smoker (vs never) |
0.94 (0.42, 2.11) |
|
|
Presence of intrathoracic involvement |
0.28 (0.08, 0.93) |
0.038 |
|
Presence of parenchymal involvement |
0.92 (0.51, 1.63) |
0.77 |
|
Symptomatic from intrathoracic involvement |
1.27 (0.705, 2.33) |
0.44 |
|
Eye |
0.46 (0.13, 1.57) |
0.22 |
|
Nervous system |
4.18 (1.44, 12.11) |
0.008 |
|
Skin |
0.84 (0.35, 2.03) |
0.70 |
|
Liver |
5.37 (1.90, 15.21) |
0.002 |
|
Spleen |
11.54 (4.05, 32.91) |
<0.001 |
|
Heart |
12.35 (2.76, 55.18) |
0.001 |
|
Kidney |
2.46 (0.72, 8.39) |
0.15 |
|
Exocrine gland |
0.43 (0.06, 3.15) |
0.40 |
To cite this abstract in AMA style:
Ungprasert P, Carmona Porquera EM, Utz JP, Ryu JH, Crowson CS, Matteson EL. Predictors of Mortality Among Patients with Sarcoidosis: A Population-Based Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/predictors-of-mortality-among-patients-with-sarcoidosis-a-population-based-study/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/predictors-of-mortality-among-patients-with-sarcoidosis-a-population-based-study/