TY - JOUR
T1 - Outcome of pulmonary sarcoidosis
T2 - A population-based study 1976-2013
AU - Ungprasert, Patompong
AU - Crowson, Cynthia S.
AU - Carmona, Eva M.
AU - Matteson, Eric L.
N1 - Funding Information:
sources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676, and CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© Mattioli 1885.
PY - 2018/8/9
Y1 - 2018/8/9
N2 - Background: A hallmark of sarcoidosis is lung disease. However, the prognosis and long-term outcome of pulmonary sarcoidosis are not well-defined due to the limited number of studies with long duration of follow-up. Objectives: This study was undertaken to characterize the course of pulmonary sarcoidosis in a population-based cohort. Methods: A population-based cohort of 311 incident cases of pulmonary sarcoidosis among Olmsted County, Minnesota residents in 1976-2013 were identified. Medical records of the confirmed cases were reviewed from diagnosis to last follow-up. Data on stage of pulmonary sarcoidosis at diagnosis, serial pulmonary function tests, requirement of oxygen therapy and treatment were abstracted. The cumulative incidence of chronic respiratory impairment (defined as forced vital capacity of <50%, diffuse capacity for carbon monoxide of <40% or requirement to use oxygen supplementation) adjusted for the competing risk of death was estimated. Cox models were used to assess the association of stage of pulmonary sarcoidosis and treatment on the development of chronic respiratory impairment. Results: 25 patients developed chronic respiratory impairment which corresponded to a 10-year event rate of 4.4% (95% confidence interval [CI], 1.9.-6.9). Stage of pulmonary sarcoidosis at diagnosis was a strong predictor for chronic respiratory impairment with hazard ratio compared with stage I of 5.29 (95% CI, 1.65-16.96) for stage II and 8.36 (95% CI, 26.3-26.52) for stage III and IV. Use of glucocorticoids and immunosuppressive agents was associated with a significantly increased risk of chronic respiratory impairment. Conclusion: Patients with pulmonary sarcoidosis have a good pulmonary prognosis with a low incidence of chronic respiratory impairment.
AB - Background: A hallmark of sarcoidosis is lung disease. However, the prognosis and long-term outcome of pulmonary sarcoidosis are not well-defined due to the limited number of studies with long duration of follow-up. Objectives: This study was undertaken to characterize the course of pulmonary sarcoidosis in a population-based cohort. Methods: A population-based cohort of 311 incident cases of pulmonary sarcoidosis among Olmsted County, Minnesota residents in 1976-2013 were identified. Medical records of the confirmed cases were reviewed from diagnosis to last follow-up. Data on stage of pulmonary sarcoidosis at diagnosis, serial pulmonary function tests, requirement of oxygen therapy and treatment were abstracted. The cumulative incidence of chronic respiratory impairment (defined as forced vital capacity of <50%, diffuse capacity for carbon monoxide of <40% or requirement to use oxygen supplementation) adjusted for the competing risk of death was estimated. Cox models were used to assess the association of stage of pulmonary sarcoidosis and treatment on the development of chronic respiratory impairment. Results: 25 patients developed chronic respiratory impairment which corresponded to a 10-year event rate of 4.4% (95% confidence interval [CI], 1.9.-6.9). Stage of pulmonary sarcoidosis at diagnosis was a strong predictor for chronic respiratory impairment with hazard ratio compared with stage I of 5.29 (95% CI, 1.65-16.96) for stage II and 8.36 (95% CI, 26.3-26.52) for stage III and IV. Use of glucocorticoids and immunosuppressive agents was associated with a significantly increased risk of chronic respiratory impairment. Conclusion: Patients with pulmonary sarcoidosis have a good pulmonary prognosis with a low incidence of chronic respiratory impairment.
KW - Outcome
KW - Pulmonary function test
KW - Sarcoidosis
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M3 - Article
AN - SCOPUS:85052377911
SN - 1124-0490
VL - 35
SP - 123
EP - 128
JO - Sarcoidosis
JF - Sarcoidosis
IS - 2
ER -