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Lung. 2018 Apr;196(2):239-248. doi: 10.1007/s00408-017-0076-4. Epub 2017 Dec 11.

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

Author information

1
Laboratory of Systemic Autoimmune Diseases "Josep Font", CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Systemic Autoimmune Diseases, ICMID, Hospital Clinic, C/Villarroel, 170, 08036, Barcelona, Spain.
2
Autoimmune Diseases Unit, Department of Internal Medicine, Hospital CIMA-Sanitas, Barcelona, Spain.
3
Department of Statistics, Faculty of Science and Letters, Mimar Sinan Fine Arts University, Istanbul, Turkey.
4
Primary Healthcare Transversal Research Group, IDIBAPS, Primary Care Center Les Corts, CAPSBE, Barcelona, Spain.
5
Quick Diagnosis Unit, Department of Internal Medicine, ICMID, Hospital Clinic, Barcelona, Spain.
6
Department of Pneumology, ICR, Hospital Clinic, Barcelona, Spain.
7
Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
8
Department of Radiology, Hospital Clinic, Barcelona, Spain.
9
Department of Pathology, Hospital Clinic, Barcelona, Spain.
10
Department of Nuclear Medicine, Hospital Clínic, Barcelona, Spain.
11
Department of Cardiology, ICCV, Hospital Clínic, Barcelona, Catalonia, Spain.
12
Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic, Barcelona, Spain.
13
Laboratory of Systemic Autoimmune Diseases "Josep Font", CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Systemic Autoimmune Diseases, ICMID, Hospital Clinic, C/Villarroel, 170, 08036, Barcelona, Spain. mramos@clinic.ub.es.

Abstract

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.

KEYWORDS:

Clinical Risk Groups; Comorbidity; Complexity; Sarcoidosis

PMID:
29230534
DOI:
10.1007/s00408-017-0076-4
[Indexed for MEDLINE]

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