Understanding the prevalence, in-hospital mortality and readmission rates amongst pulmonary vs cardiac sarcoidosis patients: insights from a nationwide registry.

Abstract

Objectives: Sarcoidosis is a multisystem granulomatous disorder, with pulmonary sarcoidosis (PS) affecting approximately 90% of patients and cardiac sarcoidosis (CS) being less common but associated with severe clinical implications. While PS is primarily characterized by respiratory symptoms, CS can lead to serious complications like heart failure and arrhythmias, contributing to sarcoidosis-related mortality. This study aims to compare the prevalence, in-hospital mortality, 30-day readmission rates, and healthcare costs between PS and CS patients using data from the Nationwide Readmissions Database (NRD).

Methods: Data were extracted from the NRD for adult patients diagnosed with PS or CS from January 2016 to December 2020. Baseline demographics, comorbidities, in-hospital outcomes, and 30-day readmission rates were analyzed. Statistical comparisons were made using appropriate tests for categorical and continuous variables.

Results: Among 101,365 patients, 96,905 had PS and 4,460 had CS. CS patients experienced significantly higher rates of cardiovascular complications, such as heart failure (77.1% vs. 31.1%) and arrhythmias (75.8% vs. 27.7%), and incurred higher hospital charges ($59,520 vs. $40,249; P < 0.001). In-hospital mortality was similar between groups (CS: 2.4% vs. PS: 2.8%; P = 0.090). The 30-day readmission rate was comparable (CS: 12.9% vs. PS: 11.9%; P = 0.400), but PS patients were more likely to be readmitted for respiratory complications, while CS patients were readmitted primarily for heart failure.

Conclusions: This study underscores the distinct clinical profiles of PS and CS. Although CS is less prevalent, it is associated with a higher cardiovascular burden and healthcare costs. Both groups exhibited similar mortality and readmission rates, though their readmission causes differed. These findings highlight the need for targeted management strategies for PS and CS to optimize patient outcomes and resource utilization.