Increased Risk of Multimorbidity in Patients With Sarcoidosis: A Population-Based Cohort Study 1976 to 2013

Abstract

Objective To evaluate the risk and pattern of multimorbidity in patients with sarcoidosis. Methods A cohort of Olmsted County, Minnesota residents first diagnosed with sarcoidosis between January 1, 1976 and December 31, 2013 was identified through the medical record-linkage system of the Rochester Epidemiology Project. Diagnosis was verified based on individual medical record review. A cohort of sex and age-matched comparators without sarcoidosis was assembled from the same population. Data on 18 chronic conditions recommended by the United States Department of Health and Human Services for both cases and comparators were retrieved and compared. Results The prevalence of multimorbidity (i.e., the presence of 2 or more chronic conditions) was similar between the 2 groups (111/345 cases and 110/345 comparator, P=.99). After index date, 156 cases and 142 comparators developed multimorbidity, corresponding to HR of 1.60 (95% CI, 1.27 – 2.01; P<.001). The cumulative incidence of the presence of ≥ 3, 4 and 5 chronic conditions was also consistently significantly higher among cases than comparators. Analysis by specific type of chronic condition revealed a significantly higher cumulative incidence of coronary artery disease, congestive heart failure, arrhythmia, stroke/transient ischemic attack, arthritis, depression, diabetes and major osteoporotic fracture. Conclusion In this population, patients with sarcoidosis had a significantly higher risk of developing multimorbidity compared with sex and age-matched subjects without sarcoidosis.

Epidemiology of Sarcoidosis in the Precarpathian region of Ukraine

“…In view of the results of patients' management in Minnesota (USA) from 1946 to 2013, the researchers have registered the increase in the age-related morbidity rate among women, thus, in 1950, the peak of the morbidity rate was observed between 40-59 years, and in 2010 -50-69 years. Similar situation was observed among men: in 1950, the peak morbidity rate was registered at the age range of 30-49 years, and in 2010 this rate increased to 40-59 years [4]- [7].…”

“…Foreign studies show that the most common comorbid pathologies of sarcoidosis were: diseases of the circulatory system, chronic bronchitis, diabetes mellitus, thyroid gland disorders and damage to the gastrointestinal tract [2], [7]- [9]. It may be noted that the most common comorbid conditions observed in investigated patients were diseases of the circulatory system (ischemic heart disease, hypertensive disease) -30,5% and respiratory organs (chronic bronchitis, COPD) -15,1%, while the pathologies of ENT organs (5,0%), urinary system (4,2%) and skin (1,2%) were comparatively rare [17].…”

“…The research works [6] and [7], show that people with excessive body weight are at higher risk to develop sarcoidosis of respiratory organs as compared to smokers. We have also diagnosed various levels of obesity in 93 patients (33,5%).…”

Epidemiology of sarcoidosis: current findings and future directions

“…30 Several recent investigations have elucidated the comorbidity burden on patients with sarcoidosis, and are summarized in Table 2. These studies have examined multimorbidity, 27,31 infection, 28,32 malignancy, 33,34 cardiovascular disease, 29 venous thromboembolism, 35,36 fractures, 37,38 and autoimmune diseases. 7 Patients with sarcoidosis are hospitalized more often than individuals without sarcoidosis 39 and in-hospital mortality is higher.…”

Sarcoidosis: A benign disease or a culture of neglect?

“…To further complicate matters, current statements of sarcoidosisassociated mortality do not take into account major co-morbidities that may be, in large part, ascribable to long-standing sarcoidosis therapies. The increased prevalence of comorbidities in sarcoidosis patients (compared to age/gender matched controls), their impact on quality of life and their association with increased mortality are well-documented [10][11][12][13][14][15][16]. In large patient cohorts, sarcoidosis has been associated with a higher incidence of coronary artery disease, stroke or transient ischemic attacks, arthritis, depression, diabetes, and major osteoporotic fractures [13,14,16], with strong linkages between mortality and the number of comorbidities and with a comorbidity burden score [14,15].…”