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瑞典的结节病与共病风险及死亡率增加

Sarcoidosis and increased risk of comorbidities and mortality in sweden.

作者信息

Larsson Johanna, Graff Pål, Bryngelsson Ing-Liss, Vihlborg Per

机构信息

Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.

National Institute of Occupational Health, Department of Chemical and Biological Work Environment, Oslo, Norway.

出版信息

Sarcoidosis Vasc Diffuse Lung Dis. 2020;37(2):104-135. doi: 10.36141/svdld.v37i2.9142. Epub 2020 Jun 30.

Abstract

INTRODUCTION

Sarcoidosis is a systemic inflammatory disorder, with an unclear etiology, involving granuloma formation that in most cases affects the lungs and intrathoracic lymph nodes. Sarcoidosis occurs in an acute or chronic form, each with different clinical presentation and prognosis.

METHODS

Case-control study of comorbidity and mortality in people diagnosed with sarcoidosis (ICD10 code D86) from 2007 through 2016 in Sweden. Controls were matched to cases (2:1) based on age, sex and county at the time of diagnosis. Data was collected from the Swedish National Patient Register and The Cause of Death Register. All men and women aged 20-65 years old who were diagnosed with sarcoidosis (D86, ICD10) during the years of study were included, resulting 7828 cases and 15656 controls.

RESULTS

Patients with sarcoidosis had increased mortality compared to matched controls (hazard ratio 1.88; 95% CI 1.56 - 2.26) and the Swedish general population (standardized mortality ratios1.75; 95% CI 1.52 - 2.00). The sarcoid cases, compared to controls, also had a significantly greater number of inpatient visits within several different chapters of ICD10 e.g. cardiomyopathy, heart failure, pulmonary embolism and malignant neoplasm.

CONCLUSION

Individuals with sarcoidosis are at higher risk of comorbidities and mortality than matched controls as well as the general population of Sweden. These findings are important knowledge for healthcare professionals who meet sarcoid patients, to encourage identification and treatment of comorbidities to reduce the risk of impaired quality of life and, eventually, premature death. .

摘要

引言

结节病是一种全身性炎症性疾病,病因不明,会形成肉芽肿,多数情况下会影响肺部和胸内淋巴结。结节病有急性或慢性两种形式,每种形式的临床表现和预后都不同。

方法

对2007年至2016年在瑞典被诊断为结节病(国际疾病分类第十版代码D86)的患者的合并症和死亡率进行病例对照研究。对照组根据诊断时的年龄、性别和所在县与病例进行匹配(2:1)。数据从瑞典国家患者登记册和死亡原因登记册收集。纳入了在研究期间所有年龄在20至65岁之间被诊断为结节病(D86,国际疾病分类第十版)的男性和女性,共7828例病例和15656名对照。

结果

与匹配的对照组相比,结节病患者的死亡率更高(风险比1.88;95%置信区间1.56 - 2.26),与瑞典普通人群相比也更高(标准化死亡比为1.75;95%置信区间1.52 - 2.00)。与对照组相比,结节病病例在国际疾病分类第十版的几个不同章节中,如心肌病、心力衰竭、肺栓塞和恶性肿瘤,住院就诊次数也显著更多。

结论

与匹配的对照组以及瑞典普通人群相比,结节病患者发生合并症和死亡的风险更高。这些发现对于接触结节病患者的医疗保健专业人员来说是重要的知识,有助于鼓励识别和治疗合并症,以降低生活质量受损以及最终过早死亡的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5b1/7569548/e4f76025e501/SVDLD-37-104-g001.jpg

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