1 Division of Rheumatology, Department of Internal Medicine.
2 Division of Biomedical Statistics and Informatics, Department of Health Science Research; and.
Ann Am Thorac Soc. 2017 May;14(5):676-681. doi: 10.1513/AnnalsATS.201610-750OC.
Patients with sarcoidosis may have an increased risk of infection similar to other immune-mediated disorders. However, the data are still limited.
To investigate the risk of hospitalized infection among patients with sarcoidosis, using a population-based cohort.
Using the Rochester Epidemiology Project record-linkage system, a cohort of incident cases of sarcoidosis in Olmsted County, Minnesota from 1976 to 2013 was identified. Diagnosis was confirmed by individual medical record review. For each patient with sarcoidosis, a sex- and age-matched comparator without sarcoidosis was randomly selected from the same population. Medical records of cases and comparators were individually reviewed for hospitalized infection that occurred after the index date. The cumulative incidence of hospitalized infection overall and by type of infection, adjusted for the competing risk of death, was estimated. Cox models were used to compare the rate of first hospitalized infection between cases and comparators and to evaluate the association between use of immunosuppressive agents and hospitalized infection among cases.
Three hundred and forty-five cases and 345 comparators were identified. Patients with sarcoidosis had a higher risk of a hospitalized infection with a hazard ratio (HR) of 2.00 (95% confidence interval [CI], 1.41-2.84), adjusted for age, sex, and calendar year of index date. Use of oral glucocorticoids was a significant predictor of hospitalized infection with an HR of 3.03 (95% CI, 1.33-6.90) for oral glucocorticoids not exceeding 10 mg/day and an HR of 4.48 (95% CI, 1.54-13.03) for oral glucocorticoids greater than 10 mg/day.
Patients with sarcoidosis are at increased risk of hospitalized infection. Glucocorticoid therapy is strongly associated with this increased risk.
类肉瘤病患者的感染风险可能类似于其他免疫介导性疾病患者，有所增加。然而，相关数据仍然有限。
使用基于人群的队列研究，调查类肉瘤病患者住院感染的风险。
利用罗切斯特流行病学项目的记录链接系统，确定了明尼苏达州奥姆斯特德县 1976 年至 2013 年期间类肉瘤病的发病队列。通过个体病历回顾来确认诊断。为每例类肉瘤病患者，从同一人群中随机选择一名性别和年龄匹配的非类肉瘤病对照者。单独审查病例和对照者的病历，以确定在索引日期后发生的住院感染。根据死亡的竞争风险来估计总体和各种感染类型的住院感染累积发生率。使用 Cox 模型比较病例和对照者首次住院感染的发生率，并评估病例中免疫抑制药物的使用与住院感染之间的关系。
共确定了 345 例病例和 345 名对照者。校正年龄、性别和索引日期的日历年后，类肉瘤病患者的住院感染风险更高，风险比（HR）为 2.00（95%置信区间[CI]，1.41-2.84）。口服糖皮质激素的使用是住院感染的一个显著预测因素，每日口服糖皮质激素剂量不超过 10mg 时，HR 为 3.03（95%CI，1.33-6.90），每日口服糖皮质激素剂量超过 10mg 时，HR 为 4.48（95%CI，1.54-13.03）。
类肉瘤病患者的住院感染风险增加。糖皮质激素治疗与这种风险增加密切相关。
