Journal Article

The Burden of Comorbidity and Complexity in Sarcoidosis: Impact of Associated Chronic Diseases

Hernández, Fernanda, Sisó-Almirall, Antoni, Agustí, Carles, Sellarés, Jacobo, Ramírez, José, Villalta, Mireia, Galceran-Chaves, Celeste, Brito-Zerón, Pilar, Vilanova, Sergi, Acar-Denizli, Nihan, Berruezo, Antonio, Ramos-Casals, Manuel, Bosch, Xavier, Sanchez, Marcelo, Xaubet, Antoni, Kostov, Belchin, Muxí, Africa, Paradela, Marina

2018

Overview

Purpose To evaluate comorbidity, complexity and poor outcomes in patients with sarcoidosis and to compare those scores with a control group. Methods 218 consecutive patients were diagnosed with sarcoidosis according to the ATS/ERS/WASOG criteria; extrathoracic involvement was evaluated using the 2014 WASOG organ assessment instrument. Sarcoidosis patients were compared with an age- and gender-matched control group of primary care outpatients without sarcoidosis. Comorbidities were assessed retrospectively using the Charlson Comorbidity Index (CCI); complexity was evaluated according to the classification into Clinical Risk Groups (CRG) and severity levels. Results The cohort included 142 women and 76 men; the mean age was 47.1 years at diagnosis of sarcoidosis and 55.9 years at the last visit. Patients with a CCI > 1 had a higher frequency of calcium/vitamin D abnormalities ( p  < 0.001), kidney involvement ( p  = 0.005) and a higher mortality rate ( p  < 0.001) compared with patients with a CCI ≤ 1. Patients with a CRG ≥ 6 had a higher frequency of extrathoracic involvement ( p  = 0.039), calcium/vitamin D abnormalities ( p  = 0.019) and treatment with glucocorticoids ( p  = 0.032) compared with patients with a CRG < 6. 11% patients died after a mean follow-up of 102.3 months. Country of birth, kidney involvement and extrathoracic disease were significantly associated with death. Patients with sarcoidosis had a higher frequency of liver ( p  < 0.001), pulmonary ( p  = 0.002) and autoimmune disease ( p  = 0.011) and cancer ( p  = 0.007) compared with the control group. Conclusion We found higher rates of comorbidity and complexity in patients with sarcoidosis compared with a control group. Liver, pulmonary, autoimmune and neoplastic diseases were the main comorbidities found in patients with sarcoidosis.

• Publisher: Springer US,Springer,Springer Nature B.V
• Subject: Abnormalities / Adolescent / Adult / Aged / Aged, 80 and over / Calcium / Cancer / Care and treatment / Chronic illnesses / Comorbidity / Complexity / Complications and side effects / Control equipment / Female / Glucocorticoids / Health care / Humans / Interstitial Lung Disease / Kidney transplantation / Kidneys / Liver / Lung diseases / Male / Medicine / Medicine & Public Health / Middle Aged / Patients / Pneumology/Respiratory System / Prognosis / Retrospective Studies / Risk Assessment / Risk Factors / Risk groups / Sarcoidosis / Sarcoidosis - diagnosis / Sarcoidosis - epidemiology / Sarcoidosis - mortality / Sarcoidosis - therapy / Spain - epidemiology / Vitamin D / Young Adult