Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA.
Lung. 2019 Apr;197(2):165-171. doi: 10.1007/s00408-019-00210-x. Epub 2019 Feb 23.
To investigate inpatient prevalence, expenditures, and comorbidities of hospitalized patients with sarcoidosis in the USA.
Patients with sarcoidosis were identified within the Nationwide Inpatient Sample (NIS) database for the years 2013 and 2014 using the respective ICD-9 diagnostic code. Data on patient and hospital characteristics, comorbidities, total hospital costs, and total hospitalization charges were collected. A propensity-matched cohort of patients without sarcoidosis from the same database was created and used as comparators for the analysis of comorbidities.
A cohort of 78,055 patients with sarcoidosis was identified within the database, corresponding to an inpatient prevalence of 2.21 cases per 1000 admissions. Analysis of comorbidities found that patients with sarcoidosis had significantly higher odds of atrial fibrillation [adjusted odds ratio (aOR): 1.41, 95% CI 1.13-1.76, p < 0.01], conduction abnormalities [aOR: 2.04, 95% CI 1.45-2.89, p < 0.01], aortic valvulopathy [aOR: 1.78, 95% CI 1.30-2.44, p < 0.01], congestive heart failure [aOR: 1.23, 95% CI 1.04-1.45, p = 0.02], cardiomyopathy [aOR: 1.25, 95% CI 1.08-1.44, p < 0.01], deep venous thrombosis (aOR: 1.58, p < 0.01), pulmonary embolism (aOR: 1.70, p < 0.01), and osteoporosis (aOR: 1.81, p < 0.01), compared with propensity-matched patients without sarcoidosis. After adjusting for confounders, patients with sarcoidosis displayed a mean additional $1,250 (p = 0.24) in total hospital costs and a mean additional $27,205 (p < 0.01) in total hospitalization charges when compared to hospitalized patients without sarcoidosis.
The inpatient prevalence of sarcoidosis was relatively high compared with its overall incidence. Hospitalization of patients with sarcoidosis was associated with a significantly higher total hospitalization charges compared to hospitalized patients without sarcoidosis. Patients with sarcoidosis have a higher risk of several cardiac comorbidities.
调查美国住院的结节病患者的住院率、支出和合并症。
在 2013 年和 2014 年，使用各自的 ICD-9 诊断代码，在全国住院患者样本（NIS）数据库中确定结节病患者。收集患者和医院特征、合并症、总住院费用和总住院费用的数据。从同一数据库中创建了一组没有结节病的匹配倾向患者作为分析合并症的对照组。
在数据库中确定了 78055 名患有结节病的患者，住院率为每 1000 次入院 2.21 例。对合并症的分析发现，患有结节病的患者发生心房颤动的几率显著增加[校正优势比（aOR）：1.41，95%置信区间 1.13-1.76，p<0.01]、传导异常[aOR：2.04，95%置信区间 1.45-2.89，p<0.01]、主动脉瓣病变[aOR：1.78，95%置信区间 1.30-2.44，p<0.01]、充血性心力衰竭[aOR：1.23，95%置信区间 1.04-1.45，p=0.02]、心肌病[aOR：1.25，95%置信区间 1.08-1.44，p<0.01]、深静脉血栓形成[aOR：1.58，p<0.01]、肺栓塞[aOR：1.70，p<0.01]和骨质疏松症[aOR：1.81，p<0.01]，与无结节病的匹配患者相比。调整混杂因素后，与无结节病的住院患者相比，结节病患者的总住院费用平均增加 1250 美元（p=0.24），总住院费用平均增加 27205 美元（p<0.01）。
与结节病的总体发病率相比，其住院率相对较高。与无结节病的住院患者相比，结节病患者的住院总费用明显更高。结节病患者发生多种心脏合并症的风险更高。
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