D-6 | Identifying Disparities in Patients with Sarcoidosis and Concomitant Cardiogenic Shock

Sarcoidosis is a multiorgan granulomatous disease with an estimated cardiac involvement in 25% of the patients. Although cardiogenic shock as a result of myocardial fibrosis, biventricular dilation and arrhythmias is relatively uncommon, there is little literature on the rates of arrhythmias and mortality in this patient population. Our retrospective cohort study, analyzed the National Inpatient Sample Database using ICD-10 codes for patients (>age 18) with cardiac sarcoidosis and concomitant cardiogenic shock versus patients without cardiogenic shock. Data were extracted from the year 2015 to 2019 and various parameters associated with the procedure were analyzed. Multivariate logistic regression was used to adjust for patient baseline characteristics, hospital demographics, and relevant comorbidities. This study included 2106 patients with Cardiac Sarcoidosis, of which 180 patients had cardiogenic shock. Patients with sarcoidosis and cardiogenic shock and an associated arrhythmia had higher inpatient mortality (OR10.24 (CI 4.86-21.57), p<0.0001), Length of stay (LOS) ( +8.92 (CI 7.11-10.73), p<0.0001) and total hospital charges (TOTHCG) ($225,249.6 (CI 180410.6-270088.5), p<0.0001). In this patient population, secondary analysis revealed that mortality was increased if patients had acute myocardial infarction (AMI) (OR 17.29 (CI 1.85-161.26), p= 0.012). LOS was increased in the presence of an AKI (+9.59 (CI 1.09- 18.10), p=0.028) and TOTHCG was increased in the Hispanic population ($533887.7 (CI 15862.83- 1051912), p= 0.044). Cardiac sarcoidosis when complicated by cardiogenic shock results in increased mortality, length of stay and total hospital costs. Our study identifies racial disparities and demonstrates the need to evaluate and screen patients with sarcoidosis for cardiac complications ultimately preventing cardiogenic shock and helping reduce hospital complications and the burden on the healthcare system.