Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis
Background This multicentre, international, prospective cohort study evaluated whether patients with pulmonary sarcoidosis living in neighbourhoods with greater material and social disadvantage experience worse clinical outcomes. Methods The area deprivation index and the Canadian Index of Multiple...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2022-10-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/8/4/00357-2022.full |
| _version_ | 1797809439392137216 |
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| author | Gillian C. Goobie Christopher J. Ryerson Kerri A. Johannson Spencer Keil Erin Schikowski Nasreen Khalil Veronica Marcoux Deborah Assayag Hélène Manganas Jolene H. Fisher Martin R.J. Kolb Xiaoping Chen Kevin F. Gibson Daniel J. Kass Yingze Zhang Kathleen O. Lindell S. Mehdi Nouraie |
| author_facet | Gillian C. Goobie Christopher J. Ryerson Kerri A. Johannson Spencer Keil Erin Schikowski Nasreen Khalil Veronica Marcoux Deborah Assayag Hélène Manganas Jolene H. Fisher Martin R.J. Kolb Xiaoping Chen Kevin F. Gibson Daniel J. Kass Yingze Zhang Kathleen O. Lindell S. Mehdi Nouraie |
| author_sort | Gillian C. Goobie |
| collection | DOAJ |
| description | Background
This multicentre, international, prospective cohort study evaluated whether patients with pulmonary sarcoidosis living in neighbourhoods with greater material and social disadvantage experience worse clinical outcomes.
Methods
The area deprivation index and the Canadian Index of Multiple Deprivation evaluate neighbourhood-level disadvantage in the US and Canada, with higher scores reflecting greater disadvantage. Multivariable linear regression evaluated associations of disadvantage with baseline forced vital capacity (FVC) or diffusing capacity of the lung for carbon monoxide (DLCO) and linear mixed effects models for associations with rate of FVC or DLCO decline, and competing hazards models were used for survival analyses in the US cohort, evaluating competing outcomes of death or lung transplantation. Adjustments were made for age at diagnosis, sex, race and smoking history.
Results
We included 477 US and 122 Canadian patients with sarcoidosis. Higher disadvantage was not associated with survival or baseline FVC. The highest disadvantage quartile was associated with lower baseline DLCO in the US cohort (β = −6.80, 95% CI −13.16 to −0.44, p=0.04), with similar findings in the Canadian cohort (β = −7.47, 95% CI −20.28 to 5.33, p=0.25); with more rapid decline in FVC and DLCO in the US cohort (FVC β = −0.40, 95% CI −0.70 to −0.11, p=0.007; DLCO β = −0.59, 95% CI −0.95 to −0.23, p=0.001); and with more rapid FVC decline in the Canadian cohort (FVC β = −0.80, 95% CI −1.37 to −0.24, p=0.003).
Conclusion
Patients with sarcoidosis living in high disadvantage neighbourhoods experience worse baseline lung function and more rapid lung function decline, highlighting the need for better understanding of how neighbourhood-level factors impact individual patient outcomes. |
| first_indexed | 2024-03-13T06:52:49Z |
| format | Article |
| id | doaj.art-7c20d9abe6ee4610b0d2444e60d3a167 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-13T06:52:49Z |
| publishDate | 2022-10-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-7c20d9abe6ee4610b0d2444e60d3a1672023-06-07T13:30:36ZengEuropean Respiratory SocietyERJ Open Research2312-05412022-10-018410.1183/23120541.00357-202200357-2022Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosisGillian C. Goobie0Christopher J. Ryerson1Kerri A. Johannson2Spencer Keil3Erin Schikowski4Nasreen Khalil5Veronica Marcoux6Deborah Assayag7Hélène Manganas8Jolene H. Fisher9Martin R.J. Kolb10Xiaoping Chen11Kevin F. Gibson12Daniel J. Kass13Yingze Zhang14Kathleen O. Lindell15S. Mehdi Nouraie16 Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada Division of Respiratory Medicine, Department of Medicine, University of Calgary, Calgary, AB, Canada Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada Division of Respirology, Critical Care and Sleep Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Division of Respiratory Medicine, Department of Medicine, McGill University, Montreal, QC, Canada Département de Médecine, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada Department of Medicine, Firestone Institute for Respiratory Health, The Research Institute of St Joe's Hamilton, St Joseph's Healthcare, McMaster University, Hamilton, ON, Canada Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Background This multicentre, international, prospective cohort study evaluated whether patients with pulmonary sarcoidosis living in neighbourhoods with greater material and social disadvantage experience worse clinical outcomes. Methods The area deprivation index and the Canadian Index of Multiple Deprivation evaluate neighbourhood-level disadvantage in the US and Canada, with higher scores reflecting greater disadvantage. Multivariable linear regression evaluated associations of disadvantage with baseline forced vital capacity (FVC) or diffusing capacity of the lung for carbon monoxide (DLCO) and linear mixed effects models for associations with rate of FVC or DLCO decline, and competing hazards models were used for survival analyses in the US cohort, evaluating competing outcomes of death or lung transplantation. Adjustments were made for age at diagnosis, sex, race and smoking history. Results We included 477 US and 122 Canadian patients with sarcoidosis. Higher disadvantage was not associated with survival or baseline FVC. The highest disadvantage quartile was associated with lower baseline DLCO in the US cohort (β = −6.80, 95% CI −13.16 to −0.44, p=0.04), with similar findings in the Canadian cohort (β = −7.47, 95% CI −20.28 to 5.33, p=0.25); with more rapid decline in FVC and DLCO in the US cohort (FVC β = −0.40, 95% CI −0.70 to −0.11, p=0.007; DLCO β = −0.59, 95% CI −0.95 to −0.23, p=0.001); and with more rapid FVC decline in the Canadian cohort (FVC β = −0.80, 95% CI −1.37 to −0.24, p=0.003). Conclusion Patients with sarcoidosis living in high disadvantage neighbourhoods experience worse baseline lung function and more rapid lung function decline, highlighting the need for better understanding of how neighbourhood-level factors impact individual patient outcomes.http://openres.ersjournals.com/content/8/4/00357-2022.full |
| spellingShingle | Gillian C. Goobie Christopher J. Ryerson Kerri A. Johannson Spencer Keil Erin Schikowski Nasreen Khalil Veronica Marcoux Deborah Assayag Hélène Manganas Jolene H. Fisher Martin R.J. Kolb Xiaoping Chen Kevin F. Gibson Daniel J. Kass Yingze Zhang Kathleen O. Lindell S. Mehdi Nouraie Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis ERJ Open Research |
| title | Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis |
| title_full | Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis |
| title_fullStr | Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis |
| title_full_unstemmed | Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis |
| title_short | Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis |
| title_sort | neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis |
| url | http://openres.ersjournals.com/content/8/4/00357-2022.full |
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