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

被引：43

作者：

Brito-Zeron, Pilar ^{[1
,2
]}

Acar-Denizli, Nihan ^{[3
]}

Siso-Almirall, Antoni ^{[4
]}

Bosch, Xavier ^{[5
]}

Hernandez, Fernanda ^{[6
]}

Vilanova, Sergi ^{[4
]}

Villalta, Mireia ^{[4
]}

Kostov, Belchin ^{[4
]}

Paradela, Marina ^{[7
]}

Sanchez, Marcelo ^{[8
]}

Ramirez, Jose ^{[9
]}

Muxi, Africa ^{[10
]}

Berruezo, Antonio ^{[11
]}

Galceran-Chaves, Celeste ^{[12
]}

Xaubet, Antoni ^{[6
]}

Agusti, Carles ^{[6
]}

Sellares, Jacobo ^{[6
]}

Ramos-Casals, Manuel ^{[1
]}

机构：

[1] Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Dept Syst Autoimmune Dis, Lab Syst Autoimmune Dis Josep Font,CELLEX,ICMID, C Villarroel 170, Barcelona 08036, Spain

[2] Hosp CIMA Sanitas, Dept Internal Med, Autoimmune Dis Unit, Barcelona, Spain

[3] Mimar Sinan Fine Arts Univ, Fac Sci & Letters, Dept Stat, Istanbul, Turkey

[4] CAPSBE, Primary Healthcare Transversal Res Grp, Primary Care Ctr Les Corts, IDIBAPS, Barcelona, Spain

[5] Hosp Clin Barcelona, Dept Internal Med, Quick Diag Unit, ICMID, Barcelona, Spain

[6] Hosp Clin Barcelona, Dept Pneumol, ICR, Barcelona, Spain

[7] Hosp Clin Barcelona, Dept Thorac Surg, Barcelona, Spain

[8] Hosp Clin Barcelona, Dept Radiol, Barcelona, Spain

[9] Hosp Clin Barcelona, Dept Pathol, Barcelona, Spain

[10] Hosp Clin Barcelona, Dept Nucl Med, Barcelona, Spain

[11] Hosp Clin Barcelona, Dept Cardiol, ICCV, Barcelona, Catalonia, Spain

[12] Hosp Clin Barcelona, Dept Child & Adolescent Psychiat & Psychol, Barcelona, Spain

来源：

LUNG | 2018年 / 196卷 / 02期

关键词：

Sarcoidosis; Comorbidity; Complexity; Clinical Risk Groups; SYSTEMIC-LUPUS-ERYTHEMATOSUS; CANCER-RISK; MORTALITY; COHORT; HOSPITALIZATION; METAANALYSIS; INVOLVEMENT; PHENOTYPES; MORBIDITY; HEPATITIS;

D O I：

10.1007/s00408-017-0076-4

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

To evaluate comorbidity, complexity and poor outcomes in patients with sarcoidosis and to compare those scores with a control group. 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. 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. 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.

引用

页码：239 / 248

页数：10

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