Sarcoidosis deaths in the United States: 1999–2016 - 16/03/19

Doi : 10.1016/j.rmed.2018.11.010

Gregory D. Kearney ^a,^⁎ , Ogugua Ndili Obi ^b , Veeranna Maddipati ^b , Arjun Mohan ^b , Anagha Malur ^b , J. Christopher Carter ^a , Mary Jane Thomassen ^c
^a Department of Public Health, Brody School of Medicine, East Carolina University, USA
^b Department of Internal Medicine, Division of Pulmonary and Critical Care, Brody School of Medicine, East Carolina University, USA
^c Program in Lung Cell Biology and Translational Research, Division of Pulmonary and Critical Care, Brody School of Medicine, East Carolina University, USA

^∗Corresponding author. East Carolina Heart Institute, 115 Heart Drive, MS 660, Greenville, NC, 27834, USA.East Carolina Heart Institute115 Heart DriveMS 660GreenvilleNC27834USA

Abstract

Background

It has been over a decade since a comprehensive study has been published that has examined sarcoidosis deaths at the national level. The purpose of this study was to analyze sarcoidosis as the underlying cause of death using current national death certificate data. Results from this project can be used to evaluate and compare trends of sarcoidosis reported deaths across the U.S.

Methods

Mortality data from 1999 to 2016 were provided by the National Vital Statistics System (NVSS) with sarcoidosis (ICD-D86.X) as the underlying cause of death from all resident death certificates filed in the 50 states and the District of Columbia (DC). Data were analyzed using CDC WONDER, a web-based public health database and analysis tool. Queries were used to generate number of deaths, along with unadjusted and age-adjusted death rates with 95% confidence intervals and standard errors for groups including year, census region, gender, age group, race/ethnicity and state. Joinpoint regression analysis was used to test the significance of trends in race and gender-specific rates for the 1999–2016 study period.

Results

From 1999 to 2016, there were a total of 16,665 sarcoidosis reported deaths in the U.S. The overall age-adjusted mortality rate increased from 2.1 (deaths per 1,000,000) in 1999 to 3.1 in 2002, but then remained relatively stable thereafter until the end of the study period. Female deaths increased 32.0% (from 2.5 to 3.3 per 1,000,000), while male deaths increased 73.3% (from 1.5 to 2.6 deaths per 1,000,000). The highest age-adjusted death rates were among black females (17.0 deaths per 1,000,000), and black males (12.4 deaths per 1,000,000). At the regional level, the southern U.S. had the highest overall mean age-adjusted mortality rate (3.7 deaths per 1,000,000), while black females in the Midwest (18.7 per 1,000,000) had the highest race-specific reported death rate.

Discussion

The detected increase in the total number of deaths and age-adjusted rates of sarcoidosis deaths in the U.S. is a serious health concern. Factors that contribute to sarcoidosis deaths remain uncertain and more epidemiological research studies are needed to compliment current bench science to explore and examine factors that contribute to this multifactorial, chronic disease.

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Highlights

•	The number of reported sarcoidosis deaths increased, yet age adjusted mortality has remained relatively stable since 2002.
•	Higher age-adjusted death rates were found among black females and black males.
•	The southern U.S. had the highest age-adjusted mortality rate of 3.7 deaths per 1,000,000.
•	Females had the highest death rates, but white males experienced the largest percent increase of deaths.
•	Highest mortality rates occurred in DC, SC, MD and NC.