Clinical Epidemiology Unit, Dept of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
Respiratory Medicine Unit, Dept of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Eur Respir J. 2018 Feb 21;51(2). doi: 10.1183/13993003.01815-2017. Print 2018 Feb.
We aimed to investigate sarcoidosis mortality in a large, population-based cohort, taking into account disease heterogeneity.Individuals with incident sarcoidosis (n=8207) were identified from the Swedish National Patient Register using International Classification of Disease codes (2003‒2013). In a subset, cases receiving treatment ±3 months from diagnosis were identified from the Prescribed Drug Register. Nonsarcoidosis comparators from the general population were matched to cases 10:1 on birth year, sex and county. Individuals were followed for all-cause death in the Cause of Death Register. Adjusted mortality rates, rate differences and hazard ratios (HRs) were estimated, stratifying by age, sex and treatment status.The mortality rate was 11.0 per 1000 person-years in sarcoidosis 6.7 in comparators (rate difference 2.7 per 1000 person-years). The HR for death was 1.61 (95% CI 1.47‒1.76), with no large variation by age or sex. For cases not receiving treatment within the first 3 months, the HR was 1.13 (95% CI 0.94‒1.35). The HR was 2.34 (95% CI 1.99‒2.75) for those receiving treatment.Individuals with sarcoidosis are at a higher risk of death compared to the general population. For the majority, the increased risk is small. However, patients whose disease leads to treatment around diagnosis have a two-fold increased risk of death. Future interventions should focus on this vulnerable group.
我们旨在调查大型基于人群的队列中结节病的死亡率，同时考虑疾病异质性。通过国际疾病分类代码（2003-2013 年），从瑞典国家患者登记处确定了患有结节病的患者（n=8207）。在一个亚组中，从处方药物登记处确定了在诊断后 3 个月内接受治疗的患者。在一般人群中，与结节病患者进行 10：1 配对的非结节病对照者按出生年份、性别和县进行匹配。通过死因登记处，对所有原因的死亡进行随访。通过分层年龄、性别和治疗状况，估计了调整后的死亡率、差异率和风险比（HR）。结节病的死亡率为每 1000 人年 11.0 例，对照者为每 1000 人年 6.7 例（差异率为每 1000 人年 2.7 例）。死亡的 HR 为 1.61（95%CI 1.47-1.76），年龄或性别差异不大。在头 3 个月内未接受治疗的患者中，HR 为 1.13（95%CI 0.94-1.35）。接受治疗的患者的 HR 为 2.34（95%CI 1.99-2.75）。与一般人群相比，结节病患者的死亡风险更高。对于大多数患者，风险增加很小。然而，那些疾病导致诊断时治疗的患者的死亡风险增加了两倍。未来的干预措施应集中在这一脆弱群体。
