Comorbid Illnesses and Chest Radiographic Severity in African-American Sarcoidosis Patients
Identifieur interne : 001B70 ( Main/Exploration ); précédent : 001B69; suivant : 001B71Comorbid Illnesses and Chest Radiographic Severity in African-American Sarcoidosis Patients
Auteurs : Gloria E. Westney [États-Unis] ; Sadia Habib [États-Unis] ; Alexander Quarshie [États-Unis]Source :
- Lung [ 0341-2040 ] ; 2007-05-01.
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Abstract
Abstract: Sarcoidosis disease expression differs along racial/ethnic lines and black race has been cited as a poor prognostic factor. Besides genetic, healthcare, and socioeconomic factors, comorbid illnesses may influence sarcoidosis disease expression. We set out to investigate the association between comorbid illnesses and chest radiographic severity in a population of African-American sarcoidosis patients. The study was designed as a retrospective database analysis. The hospital and outpatient databases of the Grady Health System were searched to capture adult patients between November 1999 and December 2003 with the ICD-9 codes of 135 or 519.8, along with all associated secondary and tertiary diagnostic codes. Patient electronic pathology and radiographic reports were reviewed for tissue biopsies showing noncaseating granulomas and for chest radiographic Scadding stage. A total of 165 African-American patients were identified (64% female, 43 ± 10 years old). Ninety percent (149/165) had comorbid illnesses. The most frequent chronic comorbid illnesses were hypertension (39%), diabetes mellitus (19%), anemia (19%), asthma (15%), gastroesophageal reflux disease (15%), depression (13%), and heart failure (10%). Females had increased frequency and clustering of chronic illnesses. Chest radiographic stages were more severe in patients with anemia, depression, and those less than 40 years old. Males, within each chronic illnesses category, had more severe CXR stages compared to females; however, significance was not achieved. We concluded that most adult patients with sarcoidosis have comorbid illnesses and these, in addition to gender differences, may influence sarcoidosis disease expression. Screening for comorbid illnesses should be an important aspect of sarcoidosis patient management.
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DOI: 10.1007/s00408-007-9008-z
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Westney</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Pulmonary/Critical Care Section, Department of Medicine, Morehouse School of Medicine, 720 Westview Dr. SW, 30310, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Habib, Sadia" sort="Habib, Sadia" uniqKey="Habib S" first="Sadia" last="Habib">Sadia Habib</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Morehouse School of Medicine, 30310, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Quarshie, Alexander" sort="Quarshie, Alexander" uniqKey="Quarshie A" first="Alexander" last="Quarshie">Alexander Quarshie</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Clinical Research Center, Morehouse School of Medicine, 30310, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Lung</title><title level="j" type="abbrev">Lung</title><idno type="ISSN">0341-2040</idno><idno type="eISSN">1432-1750</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>New York</pubPlace><date type="published" when="2007-05-01">2007-05-01</date><biblScope unit="volume">185</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="131">131</biblScope><biblScope unit="page" to="137">137</biblScope></imprint><idno type="ISSN">0341-2040</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0341-2040</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>African-Americans</term><term>Comorbidity</term><term>Ethnicity</term><term>Health disparities</term><term>Health services</term><term>Sarcoidosis</term><term>Thoracic radiography</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Sarcoidosis disease expression differs along racial/ethnic lines and black race has been cited as a poor prognostic factor. Besides genetic, healthcare, and socioeconomic factors, comorbid illnesses may influence sarcoidosis disease expression. We set out to investigate the association between comorbid illnesses and chest radiographic severity in a population of African-American sarcoidosis patients. The study was designed as a retrospective database analysis. The hospital and outpatient databases of the Grady Health System were searched to capture adult patients between November 1999 and December 2003 with the ICD-9 codes of 135 or 519.8, along with all associated secondary and tertiary diagnostic codes. Patient electronic pathology and radiographic reports were reviewed for tissue biopsies showing noncaseating granulomas and for chest radiographic Scadding stage. A total of 165 African-American patients were identified (64% female, 43 ± 10 years old). Ninety percent (149/165) had comorbid illnesses. The most frequent chronic comorbid illnesses were hypertension (39%), diabetes mellitus (19%), anemia (19%), asthma (15%), gastroesophageal reflux disease (15%), depression (13%), and heart failure (10%). Females had increased frequency and clustering of chronic illnesses. Chest radiographic stages were more severe in patients with anemia, depression, and those less than 40 years old. Males, within each chronic illnesses category, had more severe CXR stages compared to females; however, significance was not achieved. We concluded that most adult patients with sarcoidosis have comorbid illnesses and these, in addition to gender differences, may influence sarcoidosis disease expression. 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