Abstract
Introduction: Sarcoidosis is a systemic granulomatous inflammatory condition that often initially presents with neurological manifestations. Ischemic stroke constitutes the majority of cerebrovascular involvement in sarcoidosis, but other cerebrovascular diseases (CVD), such as hemorrhagic events have been reported. The literature lacks large-scale data on outcomes of CVD occurring in sarcoidosis. This study aimed to assess the characteristics and outcomes of CVD hospitalizations occurring with sarcoidosis.
Methods: We queried the Nationwide Readmissions Database (2016-2021) for hospitalizations involving adults (≥18 years) with a primary CVD diagnosis stratified by a diagnosis of sarcoidosis. We used propensity-score matching to account for selection bias and differences in age, Charlson comorbidity index (CCI), biological sex, discharge month, and type of CVD. Outcomes included inpatient mortality, costs, readmission rates, length of stay, and discharge disposition. Odds ratios (OR) with 95% confidence intervals (CI) and p-values were reported.
Results: There were an estimated 3,498,250 CVD hospitalizations, out of which 8,335 (0.24%) were associated with sarcoidosis. CVD-sarcoidosis hospitalizations consisted of ischemic stroke (15.20%), non-traumatic subarachnoid hemorrhage (15.74%), hemorrhagic stroke (6.03%), cerebral venous sinus thrombosis (0.73%) and other unspecified CVDs (62.29%). Sarcoidosis was associated with longer hospital stays and costs (OR = 1.09, 95% CI: 1.02 to 1.16; 1.05, 95% CI: 1.01 to 1.08). There was no significant difference in inpatient mortality or readmission rates between CVD hospitalizations with and without sarcoidosis.
Conclusion: Our study uncovered the spectrum of CVD that can occur in people with sarcoidosis. Contrary to prior reports, CVD hospitalizations with sarcoidosis did not demonstrate higher inpatient mortality or readmissions. However, they were associated with longer hospitalizations and increased costs. Sarcoidosis may increase healthcare utilization in CVD without worsening short-term survival, underscoring the need for further studies to clarify its long-term impact. Future studies with more granular patient-level data may focus on clinical and radiological features of CVD in people with sarcoidosis and its management.