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Trends in All-Cause Mortality Among US Veterans With Sarcoidosis, 2004-2022
Mohamed I Seedahmed1, Mohamed T Albirair2, Aaron D Baugh3
1Medical Service, Pittsburgh Veterans Affairs Healthcare System, University of Pittsburgh, Pittsburgh, PA; Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Chest
|November 9, 2024
Summary
Mortality in US veterans with sarcoidosis is increasing annually. Black veterans and males face higher risks, suggesting potential environmental exposure differences and the impact of universal healthcare access.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Veterans Health
Background:
- Sarcoidosis, an idiopathic multiorgan disease, has variable outcomes.
- A comprehensive analysis of sarcoidosis mortality in US veterans is lacking.
Purpose of the Study:
- To examine trends in all-cause mortality among US veterans with sarcoidosis.
- To investigate the influence of demographics, race, and geography on these mortality trends.
Main Methods:
- Retrospective cohort study using Veterans Health Administration (VHA) electronic health records (EHRs) from 2004-2022.
- Analysis of 23,745 veterans diagnosed with sarcoidosis, examining annual mortality trends and risk factors.
- Multivariable Poisson regression and marginal means procedure for trend and geographic analysis; Area Deprivation Index (ADI) used for socioeconomic disparity assessment.
Main Results:
- All-cause mortality increased by 4.7% annually (P < .0001) and was 6.4% higher in Black veterans compared to White veterans (P = .02).
- Risk factors for increased mortality included older age, male sex, Black race, and Northeast residence.
- No significant change in mortality trends was observed after ADI adjustment, and geographical variations did not show clear patterns.
Conclusions:
- Mortality among US veterans with sarcoidosis is on the rise.
- Service branch differences and higher risk in males suggest potential environmental exposure impacts.
- Narrower racial disparities and limited ADI impact may indicate the role of universal healthcare access in promoting equitable outcomes.
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