Lee Yu-Che, Chang Ko-Yun, Mirsaeidi Mehdi
Department of Medicine, University at Buffalo-Catholic Health System, Buffalo, NY 14220, USA.
Division of Chest Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
J Clin Med. 2021 May 27;10(11):2366. doi: 10.3390/jcm10112366.
Sarcoidosis is associated with significant morbidity and rising health care utilization, which contribute to the health care burden and disease outcome. In the United States (US), evaluation of sarcoidosis mortality by individual states has not been investigated.
We examined sarcoidosis mortality data for 1999-2018 from the Centers for Disease Control and Prevention (CDC). America's Health Rankings (AHR) assesses the nation's health on a state-by-state basis to determine state health rankings. The numbers of certified Sarcoidosis Clinics within the US were obtained from World Association for Sarcoidosis and Other Granulomatous Disorders (WASOG) and Foundation for Sarcoidosis Research (FSR). The associations between sarcoidosis mortality and state health disparities were calculated by linear regression analyses.
From 1999 to 2018, the mean age-adjusted mortality rate (AAMR) in all populations, African Americans and European Americans were 2.9, 14.8, and 1.4 per 1,000,000 population, respectively. South Carolina had the highest AAMR for all populations (6.6/1,000,000) and African Americans (20.8/1,000,000). Both Utah and Vermont had the highest AAMR for European Americans (2.6/1,000,000). New York State and South Atlantic had the largest numbers of FSR-WASOG Sarcoidosis Clinics (6 and 13, respectively). States with better health rankings were significantly associated with lower AAMR in all population (R = 0.170, = 0.003) but with higher AAMR in European Americans (R = 0.223, < 0.001).
There are significant variations in sarcoidosis mortality within the US. Sarcoidosis mortality was strongly associated with state health disparities. The current study suggests sarcoidosis mortality could be an indicator to reflect the state-level health care disparities in the US.
结节病与显著的发病率及不断增加的医疗保健利用率相关，这加重了医疗保健负担并影响疾病转归。在美国，尚未对各州的结节病死亡率进行评估。
我们研究了疾病控制与预防中心（CDC）1999年至2018年的结节病死亡率数据。美国健康排名（AHR）逐州评估美国健康状况以确定各州健康排名。美国境内经认证的结节病诊所数量来自结节病及其他肉芽肿性疾病世界协会（WASOG）和结节病研究基金会（FSR）。通过线性回归分析计算结节病死亡率与各州健康差异之间的关联。
1999年至2018年，所有人群、非裔美国人和欧裔美国人的年龄调整后平均死亡率（AAMR）分别为每百万人口2.9例、14.8例和1.4例。南卡罗来纳州所有人群（6.6/百万）和非裔美国人（20.8/百万）的AAMR最高。犹他州和佛蒙特州欧裔美国人的AAMR最高（2.6/百万）。纽约州和南大西洋地区的FSR-WASOG结节病诊所数量最多（分别为6家和13家）。健康排名较好的州与所有人群较低的AAMR显著相关（R = 0.170，P = 0.003），但与欧裔美国人较高的AAMR相关（R = 0.223，P < 0.001）。
美国境内结节病死亡率存在显著差异。结节病死亡率与各州健康差异密切相关。当前研究表明结节病死亡率可能是反映美国州级医疗保健差异的一个指标。
