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了解肺部结节病与心脏结节病患者的患病率、住院死亡率及再入院率:来自一项全国性登记研究的见解

Understanding the prevalence, in-hospital mortality and readmission rates amongst pulmonary vs cardiac sarcoidosis patients: insights from a nationwide registry.

作者信息

Chaudhary Shivang, Gokul Kaushik, Bhimani Simran, Maligireddy Anand, Arora Nirav, Golemi Lolita, Kilian Adam, Nayak Ravi, Mikhalkova Deana, Rojulpote Chaitanya, Lin Chien-Jung

机构信息

Department of Internal Medicine, Saint Louis University School of Medicine Saint Louis, MO, USA.

Department of Medicine, The Wright Center for Graduate Medical Education Scranton, PA, USA.

出版信息

Am J Cardiovasc Dis. 2025 Apr 25;15(2):149-155. doi: 10.62347/WJWP6904. eCollection 2025.

Abstract

OBJECTIVES

Sarcoidosis is a multisystem granulomatous disorder, with pulmonary sarcoidosis (PS) affecting approximately 90% of patients and cardiac sarcoidosis (CS) being less common but associated with severe clinical implications. While PS is primarily characterized by respiratory symptoms, CS can lead to serious complications like heart failure and arrhythmias, contributing to sarcoidosis-related mortality. This study aims to compare the prevalence, in-hospital mortality, 30-day readmission rates, and healthcare costs between PS and CS patients using data from the Nationwide Readmissions Database (NRD).

METHODS

Data were extracted from the NRD for adult patients diagnosed with PS or CS from January 2016 to December 2020. Baseline demographics, comorbidities, in-hospital outcomes, and 30-day readmission rates were analyzed. Statistical comparisons were made using appropriate tests for categorical and continuous variables.

RESULTS

Among 101,365 patients, 96,905 had PS and 4,460 had CS. CS patients experienced significantly higher rates of cardiovascular complications, such as heart failure (77.1% vs. 31.1%) and arrhythmias (75.8% vs. 27.7%), and incurred higher hospital charges ($59,520 vs. $40,249; P < 0.001). In-hospital mortality was similar between groups (CS: 2.4% vs. PS: 2.8%; P = 0.090). The 30-day readmission rate was comparable (CS: 12.9% vs. PS: 11.9%; P = 0.400), but PS patients were more likely to be readmitted for respiratory complications, while CS patients were readmitted primarily for heart failure.

CONCLUSIONS

This study underscores the distinct clinical profiles of PS and CS. Although CS is less prevalent, it is associated with a higher cardiovascular burden and healthcare costs. Both groups exhibited similar mortality and readmission rates, though their readmission causes differed. These findings highlight the need for targeted management strategies for PS and CS to optimize patient outcomes and resource utilization.

摘要

目的

结节病是一种多系统肉芽肿性疾病,肺结节病(PS)影响约90%的患者,心脏结节病(CS)较少见但具有严重的临床意义。虽然PS主要表现为呼吸道症状,但CS可导致心力衰竭和心律失常等严重并发症,是结节病相关死亡的原因之一。本研究旨在利用全国再入院数据库(NRD)的数据,比较PS和CS患者之间的患病率、住院死亡率、30天再入院率和医疗费用。

方法

从NRD中提取2016年1月至2020年12月诊断为PS或CS的成年患者的数据。分析基线人口统计学、合并症、住院结局和30天再入院率。使用适当的分类变量和连续变量检验进行统计比较。

结果

在101365例患者中,96905例患有PS,4460例患有CS。CS患者发生心力衰竭(77.1%对31.1%)和心律失常(75.8%对27.7%)等心血管并发症的发生率显著更高,住院费用也更高(59520美元对40249美元;P<0.001)。两组的住院死亡率相似(CS:2.4%对PS:2.8%;P=0.090)。30天再入院率相当(CS:12.9%对PS:11.9%;P=0.400),但PS患者因呼吸道并发症再入院的可能性更大,而CS患者主要因心力衰竭再入院。

结论

本研究强调了PS和CS不同的临床特征。虽然CS的患病率较低,但它与更高的心血管负担和医疗费用相关。两组的死亡率和再入院率相似,尽管再入院原因不同。这些发现凸显了针对PS和CS制定有针对性的管理策略以优化患者结局和资源利用的必要性。

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