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

结节病患者多重疾病风险增加:一项基于人群的队列研究(1976年至2013年)

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Abstract

OBJECTIVE: To evaluate the risk and pattern of multimorbidity in patients with sarcoidosis. PATIENTS AND METHODS: A cohort of all residents of Olmsted County, Minnesota, 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 by 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 US Department of Health and Human Services for both cases and comparators were retrieved and compared. RESULTS: The prevalence of multimorbidity (ie, the presence of ≥2 chronic conditions) was similar between the 2 groups: 111 of 345 cases (32.2%) and 110 of 345 comparators (31.9%) (P=.99). After the index date, 156 cases (43.8%) and 142 comparators (41.2%) developed multimorbidity, corresponding to a hazard ratio 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 in cases than in comparators (P value=.01, .004 and .002, respectively). Analysis by specific type of chronic condition revealed a significantly higher cumulative incidence of coronary artery disease, congestive heart failure, arrhythmia, stroke or 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 than did sex- and age-matched individuals without sarcoidosis.

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