Journal article
Income and Other Contributors to Poor Outcomes in U.S. Patients with Sarcoidosis
American journal of respiratory and critical care medicine, Vol.201(8), pp.955-964
04/15/2020
DOI: 10.1164/RCCM.201906-1250OC
PMCID: PMC7924656
PMID: 31825646
Abstract
Socioeconomic factors are associated with worse disease severity at presentation in sarcoidosis, but the relative importance of socioeconomic variables on morbidity and disease burden has not been fully elucidated.
To determine the association between income and sarcoidosis outcomes after controlling for socioeconomic and disease-related factors.
Using the Sarcoidosis Advanced Registry for Cures database, we analyzed data from 2,318 patients with sarcoidosis in the United States to determine the effect of income and other variables on outcomes. We divided comorbidities arising after diagnosis into those likely related to steroid use and those likely related to sarcoidosis. We assessed the development of health-related, functional, and socioeconomic outcomes following the diagnosis of sarcoidosis.
In multivariate analysis, low-income patients had significantly higher rates of new sarcoidosis-related comorbidities (<$35,000, odds ratio [OR], 2.4 [1.7-3.3]; $35,000-84,999, OR, 1.4 [1.1-1.9]; and ≥$85,000 [reference (Ref)]) and new steroid-related comorbidities (<$35,000, OR, 1.3 [0.9-2.0]; $35,000-84,999, OR, 1.5 [1.1-2.1]; and ≥$85,000 [Ref]), had lower health-related quality of life as assessed by the Sarcoidosis Health Questionnaire (
< 0.001), and experienced more impact on family finances (<$35,000, OR, 7.9 [4.9-12.7]; $35,000-84,999, OR, 2.7 [1.9-3.9]; and ≥$85,000 [Ref]). The use of supplemental oxygen, need for assistive devices, and job loss were more common in lower income patients. Development of comorbidities after diagnosis of sarcoidosis occurred in 63% of patients and were strong independent predictors of poor outcomes. In random forest modeling, income was consistently a leading predictor of outcome.
These results suggest the burden from sarcoidosis preferentially impacts the economically disadvantaged.
Details
- Title: Subtitle
- Income and Other Contributors to Poor Outcomes in U.S. Patients with Sarcoidosis
- Creators
- Logan J Harper - Cleveland ClinicAlicia K Gerke - University of IowaXiao-Feng Wang - Cleveland ClinicManuel L Ribeiro Neto - Department of Pulmonary Medicine, Respiratory Institute andRobert P Baughman - University of CincinnatiKelli Beyer - Pulmonary Fibrosis FoundationMarjolein Drent - Ild Care FoundationMarc A Judson - Albany Medical Center HospitalLisa A Maier - Colorado School of Public HealthLeslie Serchuck - Foundation for Sarcoidosis Research Sarcoidosis Advanced Registry for Cures Registry, Foundation for Sarcoidosis Research, Chicago, Illinois.Noopur Singh - Pulmonary Fibrosis FoundationDaniel A Culver - Lung Institute
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.201(8), pp.955-964
- DOI
- 10.1164/RCCM.201906-1250OC
- PMID
- 31825646
- PMCID
- PMC7924656
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Grant note
- P30 ES005605 / NIEHS NIH HHS
- Language
- English
- Date published
- 04/15/2020
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984359773502771
Metrics
10 Record Views