Inpatient outcomes of patients with pulmonary sarcoidosis admitted for pneumonia: results from the national inpatient sample

SESSION TITLE: Diffuse Lung Disease Posters 5 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: Sarcoidosis is a granulomatous disease affecting multiple organ systems characterized by noncaseating granulomas. It has a great predilection for the lungs manifesting as a variety of disorders ranging from sub-centimeter nodules to cavitary lung lesions and sometimes causing extensive structural lung damage thereby increasing the risk for lung infection particularly pneumonia. Our study was done to determine outcomes following hospitalization for pneumonia in sarcoidosis patients and the impact of sarcoidosis on mortality, length of stay and costs in patients admitted for pneumonia. METHODS: We used weighted data from National Inpatient Sample (NIS) database years 2018-2019 to analyze hospital admissions with a principal diagnosis of pneumonia, including all ICD codes with identifiable causes of pneumonia and ICD codes for unspecified causes of pneumonia and compared outcomes of patients with a secondary diagnosis of sarcoidosis. Primary outcomes were in-patient mortality due to any cause and need for mechanical ventilation. Secondary outcomes included length of stay and total hospital charges. We matched baseline characteristics and used multivariate logistic and linear regression to adjust for cofounders such as age, gender and other comorbidities. RESULTS: There was a total of 1,405,699 weighted admission with a principal diagnosis of pneumonia. 17% of which were attributable to bacterial pneumonia, 7.1% with pneumonia related to influenza virus, 3% with pneumonia from other viral causes and 72.9% with unspecified pneumonia. Prevalence of sarcoidosis was 0.2% of all cases of pneumonia and pooled mortality was 0.02%. After adjusting for cofounders, we found that patients with sarcoidosis had a slightly higher chance of dying, although this was not statistically significant, adjusted odds ratio (aOR) 1.01, 95% CI: 0.12 – 8.39, p=0.99. There was no difference in the need for mechanical ventilation with patients with sarcoidosis having same risk as patients without. Patients with sarcoidosis spent 1.7 days less in the hospital compared to patients without sarcoidosis p=0.003. Total charges for sarcoidosis patients on average was 16,411$ less than patients without sarcoidosis but this difference was not statistically significant p=0.13. CONCLUSIONS: The presence of sarcoidosis does not seem to have a negative impact on patients admitted and treated for pneumonia. Patients with sarcoidosis had shorter length of stay compared to patients without sarcoidosis, there was a trend towards less total hospital charges, although this difference was not significant. CLINICAL IMPLICATIONS: Sarcoidosis is not an independent risk factor for mortality in patients admitted for pneumonia, patients with sarcoidosis do not have higher risk of needing mechanical ventilation when admitted to the hospital for pneumonia. DISCLOSURES: No relevant relationships by Oluyemisi Amoda No relevant relationships by Afsana Asharaf No relevant relationships by Diana Gomez Manjarres No relevant relationships Added 10/20/2022 by Divya Patel, source=Web Response, value=Consulting fee Removed 12/06/2022 by Divya Patel, source=Web Response No relevant relationships Added 10/20/2022 by Divya Patel, source=Web Response, value=Grant/Research Support Removed 12/06/2022 by Divya Patel, source=Web Response No relevant relationships by Jean Reinoso