Elevated Mortality Risk in the First Year Post-Diagnosis of Sarcoidosis: A Comprehensive Population-Based Cohort Study.

Sarcoidosis, marked by chronic inflammation and granuloma formation, shows a variable clinical course. While many patients have benign outcomes, others face chronic, life-threatening complications. Mortality studies in sarcoidosis show mixed results due to age, ethnicity, sex, and geography, highlighting the need for a comprehensive mortality risk analysis. This study compares mortality risks between sarcoidosis patients and controls, considering demographic and clinical factors, and performs subgroup analyses across different age groups and post-diagnosis periods. This is a retrospective cohort study that used Clalit Health Services' electronic database, including patients first diagnosed with sarcoidosis from 2000 to 2016 and age- and sex-matched controls at a 1:5 ratio. Hazard ratios (HR) for all-cause mortality were obtained using the Cox proportional hazard model, adjusted for sociodemographic and clinical variables. Sarcoidosis patients showed higher mortality rates (17.7%) than controls (10.6%), with an adjusted HR of 1.79 (95% CI: 1.64-1.96, < 0.001). Subgroup analysis revealed the HR for mortality decreased with age: HR for patients under 50 was 3.04 (95% CI: 2.20-4.21), and for those over 70, it was 1.8 (95% CI: 1.69-2.11). The HR was highest in the first year post-diagnosis. Key mortality predictors included age at diagnosis, male gender, and higher Charlson comorbidity index score. Sarcoidosis patients, particularly younger ones and those with higher comorbidity burdens, have elevated mortality risks compared to controls, with the highest HR in the first year post-diagnosis. These findings highlight the most vulnerable period of the disease.