Pos0868 Mortality Risk Analysis in Sarcoidosis: A Large Scale Population Based Cohort Study

Background: Sarcoidosis, characterized by chronic progressive inflammation and granuloma formation, exhibits a highly variable clinical course. While many patients experience benign outcomes, others face chronic, potentially life-threatening complications. Mortality studies in sarcoidosis have yielded mixed results, highlighting variations influenced by age, ethnicity, sex, and geographical contexts. This inconsistency underscores the importance of a comprehensive analysis to understand the mortality risks associated with sarcoidosis. Objectives: This study aims to compare mortality risks between sarcoidosis patients and controls, considering various demographic and clinical factors, and conducting subgroup analyses to assess risks across different age groups and post-diagnosis periods. Methods: We conducted a retrospective cohort study utilizing the electronic database of Clalit Health Services. The study included all patients first diagnosed with sarcoidosis between 2000 and 2016, along with age- and sex-matched controls at a 1:5 ratio. Hazard Ratios (HR) for all-cause mortality were obtained by the Cox proportional hazard model, adjusted for sociodemographic and clinical variables. Results: Sarcoidosis patients, both men and women, showed significantly higher mortality rates (17.7%) compared to controls (10.6%), with an adjusted HR of 1.79 (95% CI: 1.64-1.96) in multivariate analysis. Subgroup analysis revealed that the HR for mortality decreased with advancing age, specifically, patients aged under 50 years had the highest HR at 3.04 (95% CI: 2.20-4.21) and patients aged above 70 years had the lowest HR at 1.8 (95% CI: 1.69-2.11). The HR was highest in the first year following the diagnosis. Key predictors of mortality within the sarcoidosis cohort included age at diagnosis, male gender, and a higher Charlson comorbidity index score. Conclusion: Sarcoidosis patients, especially younger individuals, those in the first year post-diagnosis, and with higher comorbidity burdens, exhibit elevated mortality risks compared to controls. These findings enable the identification of high-risk subgroups requiring more vigilant follow-up and underscore the need for proactive comorbidity management. REFERENCES: 1 Rossides M, Kullberg S, Askling J, Eklund A, Grunewald J, Arkema EV. Sarcoidosis mortality in Sweden: a population-based cohort study. Eur Respir J. 2018 Feb 21;51(2):1701815. 2 Park JE, Kim YS, Kang MJ, Kim CJ, Han CH, Lee SM, Park SC. Prevalence, incidence, and mortality of sarcoidosis in Korea, 2003-2015: A nationwide population-based study. Respir Med. 2018 Nov;144S:S28-S34. 3 Gerke AK. Morbidity and mortality in sarcoidosis. Curr Opin Pulm Med. 2014 Sep;20(5):472-8. Acknowledgements: NIL. Disclosure of Interests: None declared.