Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States

BackgroundRecent trends of hospitalizations and in‐hospital mortality are not well defined in sarcoidosis. We examined aforementioned trends and prevalence of cardiovascular manifestations and explored rates of implantable cardioverter‐defibrillator implantation in hospitalizations with sarcoidosis....

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Main Authors: Nirav Patel, Rajat Kalra, Rajkumar Doshi, Harpreet Arora, Navkaranbir S. Bajaj, Garima Arora, Pankaj Arora
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.117.007844
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author Nirav Patel
Rajat Kalra
Rajkumar Doshi
Harpreet Arora
Navkaranbir S. Bajaj
Garima Arora
Pankaj Arora
author_facet Nirav Patel
Rajat Kalra
Rajkumar Doshi
Harpreet Arora
Navkaranbir S. Bajaj
Garima Arora
Pankaj Arora
author_sort Nirav Patel
collection DOAJ
description BackgroundRecent trends of hospitalizations and in‐hospital mortality are not well defined in sarcoidosis. We examined aforementioned trends and prevalence of cardiovascular manifestations and explored rates of implantable cardioverter‐defibrillator implantation in hospitalizations with sarcoidosis. Methods and ResultsUsing data from the National Inpatient Sample, a retrospective population cohort from 2005 to 2014 was studied. To identify sarcoidosis, an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) diagnosis code was used. We excluded hospitalizations with myocardial infarction, coronary artery disease, and ischemic cardiomyopathy. Cardiovascular manifestations were defined by the presence of diagnosis codes for conduction disorders, arrhythmias, heart failure, nonischemic cardiomyopathy, and pulmonary hypertension. A total of 609 051 sarcoidosis hospitalizations were identified, with an age of 55±14 years, 67% women, and 50% black. The number of sarcoidosis hospitalizations increased from 2005 through 2014 (138 versus 175 per 100 000, Ptrend<0.001). We observed declining trends of unadjusted in‐hospital mortality (6.5 to 4.9 per 100 sarcoidosis hospitalizations, Ptrend<0.001). Overall ≈31% (n=188 438) of sarcoidosis hospitalizations had coexistent cardiovascular manifestations of one or more type. Heart failure (≈16%) and arrhythmias (≈15%) were the most prevalent cardiovascular manifestations. Rates of implantable cardioverter‐defibrillator placement were ≈7.5 per 1000 sarcoidosis hospitalizations (Ptrend=0.95) during the study period. Black race was associated with 21% increased risk of in‐hospital mortality (odds ratio, 1.21; 95% confidence interval, 1.16–1.27 [P<0.001]). ConclusionsSarcoidosis hospitalizations have increased over the past decade with a myriad of coexistent cardiovascular manifestations. Black race is a significant predictor of in‐hospital mortality, which is declining. Further efforts are needed to improve care in view of low implantable cardioverter‐defibrillator rates in sarcoidosis.
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spelling doaj.art-a49bf7aacaf54cd793bf0e44224db1382022-12-22T00:02:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-01-017210.1161/JAHA.117.007844Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United StatesNirav Patel0Rajat Kalra1Rajkumar Doshi2Harpreet Arora3Navkaranbir S. Bajaj4Garima Arora5Pankaj Arora6Division of Cardiovascular Disease, University of Alabama at Birmingham, ALCardiovascular Division, University of Minnesota, Minneapolis, MNDepartment of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, NYDivision of Cardiovascular Disease, University of Alabama at Birmingham, ALDivision of Cardiovascular Disease, University of Alabama at Birmingham, ALDivision of Cardiovascular Disease, University of Alabama at Birmingham, ALDivision of Cardiovascular Disease, University of Alabama at Birmingham, ALBackgroundRecent trends of hospitalizations and in‐hospital mortality are not well defined in sarcoidosis. We examined aforementioned trends and prevalence of cardiovascular manifestations and explored rates of implantable cardioverter‐defibrillator implantation in hospitalizations with sarcoidosis. Methods and ResultsUsing data from the National Inpatient Sample, a retrospective population cohort from 2005 to 2014 was studied. To identify sarcoidosis, an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) diagnosis code was used. We excluded hospitalizations with myocardial infarction, coronary artery disease, and ischemic cardiomyopathy. Cardiovascular manifestations were defined by the presence of diagnosis codes for conduction disorders, arrhythmias, heart failure, nonischemic cardiomyopathy, and pulmonary hypertension. A total of 609 051 sarcoidosis hospitalizations were identified, with an age of 55±14 years, 67% women, and 50% black. The number of sarcoidosis hospitalizations increased from 2005 through 2014 (138 versus 175 per 100 000, Ptrend<0.001). We observed declining trends of unadjusted in‐hospital mortality (6.5 to 4.9 per 100 sarcoidosis hospitalizations, Ptrend<0.001). Overall ≈31% (n=188 438) of sarcoidosis hospitalizations had coexistent cardiovascular manifestations of one or more type. Heart failure (≈16%) and arrhythmias (≈15%) were the most prevalent cardiovascular manifestations. Rates of implantable cardioverter‐defibrillator placement were ≈7.5 per 1000 sarcoidosis hospitalizations (Ptrend=0.95) during the study period. Black race was associated with 21% increased risk of in‐hospital mortality (odds ratio, 1.21; 95% confidence interval, 1.16–1.27 [P<0.001]). ConclusionsSarcoidosis hospitalizations have increased over the past decade with a myriad of coexistent cardiovascular manifestations. Black race is a significant predictor of in‐hospital mortality, which is declining. Further efforts are needed to improve care in view of low implantable cardioverter‐defibrillator rates in sarcoidosis.https://www.ahajournals.org/doi/10.1161/JAHA.117.007844cardiovascular outcomesimplantable cardioverter‐defibrillatorsarcoidosis
spellingShingle Nirav Patel
Rajat Kalra
Rajkumar Doshi
Harpreet Arora
Navkaranbir S. Bajaj
Garima Arora
Pankaj Arora
Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiovascular outcomes
implantable cardioverter‐defibrillator
sarcoidosis
title Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States
title_full Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States
title_fullStr Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States
title_full_unstemmed Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States
title_short Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States
title_sort hospitalization rates prevalence of cardiovascular manifestations and outcomes associated with sarcoidosis in the united states
topic cardiovascular outcomes
implantable cardioverter‐defibrillator
sarcoidosis
url https://www.ahajournals.org/doi/10.1161/JAHA.117.007844
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