Parrish Scott C, Lin Thuy K, Sicignano Nicholas M, Lazarus Angeline A
Fox Valley Pulmonary Medicine, Appleton, WI.
Naval Medical Center Portsmouth, Portsmouth, VA, Department of Pulmonary and Critical Care.
Sarcoidosis Vasc Diffuse Lung Dis. 2018;35(3):261-267. doi: 10.36141/svdld.v35i3.6949. Epub 2018 Apr 28.
Sarcoidosis is an inflammatory disorder of unclear etiology with historical significance in the U.S. Department of Defense (DoD). This study sought to characterize the sarcoidosis population within the DoD Military Health System (MHS). Adult patients with sarcoidosis were identified in the DoD MHS database from 01-JAN-2004 through 31-DEC-2013. Patients required ≥3 encounters with a sarcoidosis diagnosis and continuous MHS eligibility. Index was defined as date of first sarcoidosis encounter. Comorbidities were assessed within the pre-index and follow-up periods. Additionally, a subset of sarcoidosis patients was identified as having conditions that can be associated with cardiac sarcoidosis. The final sarcoidosis cohort was 9,908 patients, 57% female, and had a mean (SD) age of 53.1 (13.6) years. The region with the largest population was the east coast (45.6%). The top 5 pre-index comorbidities were hypertension (51.7%), fatigue (27.0%), anemia (21.4%), diabetes, type II (19.6%), and coronary heart disease (16.5%). Prevalence of the following conditions increased ≥2-fold from pre-index to follow-up: leukocytopenia, pulmonary hypertension, chronic kidney disease, thrombocytopenia, hypercalcemia, venous thromboembolism, congestive heart failure, seizure disorder, stroke/TIA, hypercalciuria, and arthritis. Of the sarcoidosis cohort, 21.8% (n=2,164) were identified as having cardiac conditions that can be associated with cardiac sarcoidosis. The top conditions in this cohort were cardiac arrhythmia (75.6%), congestive heart failure (20.4%), and cardiomyopathy (13.6%). The MHS has a large population of sarcoidosis patients, of which 22% had cardiac conditions that can be associated with granulomatous inflammation of the heart. Prevalence of numerous comorbid conditions increased after sarcoidosis diagnosis. .
结节病是一种病因不明的炎症性疾病,在美国国防部(DoD)具有重要的历史意义。本研究旨在描述国防部军事卫生系统(MHS)中的结节病患者群体。在国防部MHS数据库中识别出2004年1月1日至2013年12月31日期间患有结节病的成年患者。患者需要有≥3次结节病诊断记录且持续符合MHS资格。索引定义为首次结节病就诊日期。在索引前和随访期间评估合并症。此外,一部分结节病患者被确定患有可能与心脏结节病相关的疾病。最终的结节病队列包括9908名患者,其中57%为女性,平均(标准差)年龄为53.1(13.6)岁。人口最多的地区是东海岸(45.6%)。索引前的前5种合并症是高血压(51.7%)、疲劳(27.0%)、贫血(21.4%)、II型糖尿病(19.6%)和冠心病(16.5%)。从索引前到随访期间,以下疾病的患病率增加了≥2倍:白细胞减少症、肺动脉高压、慢性肾脏病、血小板减少症、高钙血症、静脉血栓栓塞、充血性心力衰竭、癫痫发作障碍、中风/短暂性脑缺血发作、高钙尿症和关节炎。在结节病队列中,21.8%(n = 2164)被确定患有可能与心脏结节病相关的心脏疾病。该队列中的主要疾病是心律失常(75.6%)、充血性心力衰竭(20.4%)和心肌病(13.6%)。MHS中有大量结节病患者,其中22%患有可能与心脏肉芽肿性炎症相关的心脏疾病。结节病诊断后,许多合并症的患病率增加。