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Impact of systemic corticosteroids on healthcare utilization in patients with sarcoidosis.
MedLine Citation:
PMID:  21446079     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: Practical complications of chronic systemic corticosteroid (SC) use in patients with sarcoidosis are poorly characterized. The objective of this study was to determine the impact of SC use in patients with sarcoidosis on unscheduled sarcoidosis-attributed and nonsarcoidosis-attributed healthcare utilization (SHCU and NSHCU, respectively).
METHODS: Retrospective analysis of patient-reported HCU between clinic visits at a university hospital sarcoidosis outpatient clinic.
RESULTS: A total of 441 included patients had a mean (standard deviation) of 2.4 (1.2) organs involved, were followed up for a mean of 2.9 (2.4) years and received a median cumulative dose of 2680 mg of prednisone. Patients in the higher 50th percentile of cumulated SC reported a higher unadjusted mean annual SHCU (0.33 versus 0.22, P < 0.0001 by Wilcoxon rank-sum test) but a similar mean annual NSHCU (0.83 versus 1.00, P = .88). After adjustment for age, race and sex, persons in the higher 50th percentile of corticosteroid exposure had a similar odds of overall NSHCU (adjusted odds ratio = 1.03, 95% CI = 0.74–1.44) but a 2.2 (95% CI = 1.5–3.3) odds of greater nonsarcoidosis attributable emergency department visits. In separate analysis of the reasons for NSHCU, persons with greater SC use had a 1.74 (95% CI = 1.16–2.62) odds of more infectious disease-related complaints and a trend toward more visits for cardiovascular problems (OR = 1.49, 95% CI = 0.96–2.32).
CONCLUSIONS: Greater SC use is associated with small but significant increase in HCU related to infection and increased unscheduled emergency department visits for complaints not directly attributable to sarcoidosis.
Authors:
Colin B Ligon; Marc A Judson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  341     ISSN:  1538-2990     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  196-201     Citation Subset:  AIM; IM    
Affiliation:
College of Medicine, Medical University of South Carolina, Charleston, 29425, USA.
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