{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T20:24:53Z","timestamp":1784492693207,"version":"3.55.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Intern Emerg Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Advanced lung disease, cardiovascular disease (CVD), infections, malignancies, and thromboembolic disease (TED) determine the mortality of patients with sarcoidosis. Our objective was to evaluate the main causes of admission and in-hospital mortality in patients with sarcoidosis in Spain. A retrospective and observational analysis of the National Registry of Hospital Discharges (RAE-CMBD) of patients admitted with a diagnosis of sarcoidosis between 2016 and 2021 was performed. A total of 18,887 admissions of patients with sarcoidosis were identified. The main causes of admission were infection (21%), sarcoidosis itself (16.4%), CVD (12.7%), and malignancies (7.1%). Overall, 892 (4.7%) patients died, mainly from infection (32.1%), CVD (16.3%) and neoplasms (12.4%), with case fatality rates of 7.2%, 6% and 8.3%, respectively. Factors associated with higher in-hospital mortality were Charlson comorbidity index (OR 1.30 95%CI 1.27\u20131.34), sarcoidosis pulmonary involvement (OR\u2009=\u20091.20, 95%CI 1.04\u20131.38), pulmonary fibrosis (OR 2.07; 95%CI 1.52\u20132.81) and CVD (OR 1.56; 95%CI 1.26\u20131.95), infection (OR 2.37; 95%CI 1.97\u20132.84), malignancies (OR 1.77; 95%CI 1.38\u20132.27) and TE-related admissions (OR 2.1, 95%CI 1.21\u20133.76). The main determinants of hospital admissions and mortality in patients with sarcoidosis are infections, CVD, neoplasm, VTE, pulmonary fibrosis, and a high comorbidity burden. While sarcoidosis itself is a common cause of admission, it is rarely the cause of death. Prevention of infections, VTE, and neoplasm, along with control of cardiovascular risk factors, may help reduce mortality in these patients.<\/jats:p>","DOI":"10.1007\/s11739-025-04221-w","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:48:13Z","timestamp":1767790093000},"page":"577-583","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of comorbidities and organ damage on hospital admissions and mortality in patients with sarcoidosis: an observational study from the Spanish National Registry"],"prefix":"10.1007","volume":"21","author":[{"given":"Susana","family":"Mellor-Pita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9798-4514","authenticated-orcid":false,"given":"V\u00edctor","family":"Moreno-Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Esteban-Sampedro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mart\u00edn-Portugu\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Mart\u00ednez-Urbistondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Tutor-Ureta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Dur\u00e1n-del Campo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rom\u00e1n","family":"Fern\u00e1ndez-Guiti\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosal\u00eda","family":"Laporta-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bego\u00f1a","family":"Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Castej\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"4221_CR1","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.medcli.2022.03.009","volume":"159","author":"P Brito-Zer\u00f3n","year":"2022","unstructured":"Brito-Zer\u00f3n P, P\u00e9rez-\u00c1lvarez R, Ramos-Casals M (2022) Sarcoidosis. Med Clin (Barc) 159:195\u2013204. https:\/\/doi.org\/10.1016\/j.medcli.2022.03.009","journal-title":"Med Clin (Barc)"},{"key":"4221_CR2","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1056\/NEJMra2101555","volume":"385","author":"M Drent","year":"2021","unstructured":"Drent M, Crouser ED, Grunewald J (2021) Challenges of sarcoidosis and its management. N Engl J Med 385:1018\u20131032. https:\/\/doi.org\/10.1056\/NEJMra2101555","journal-title":"N Engl J Med"},{"key":"4221_CR3","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1001\/jama.2022.1570","volume":"327","author":"JA Belperio","year":"2022","unstructured":"Belperio JA, Shaikh F, Abtin FG et al (2022) Diagnosis and treatment of pulmonary sarcoidosis. JAMA 327:856. https:\/\/doi.org\/10.1001\/jama.2022.1570","journal-title":"JAMA"},{"key":"4221_CR4","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.031484","author":"MC Tan","year":"2024","unstructured":"Tan MC, Yeo YH, Mirza N et al (2024) Trends and disparities in cardiovascular death in sarcoidosis: a population\u2010based retrospective study in the United States from 1999 to 2020. J Am Heart Assoc. https:\/\/doi.org\/10.1161\/JAHA.123.031484","journal-title":"J Am Heart Assoc"},{"key":"4221_CR5","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1183\/13993003.00457-2016","volume":"48","author":"Y Jamilloux","year":"2016","unstructured":"Jamilloux Y, Maucort-Boulch D, Kerever S et al (2016) Sarcoidosis-related mortality in France: a multiple-cause-of-death analysis. Eur Respir J 48:1700\u20131709. https:\/\/doi.org\/10.1183\/13993003.00457-2016","journal-title":"Eur Respir J"},{"key":"4221_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtauto.2024.100236","volume":"8","author":"V Moreno-Torres","year":"2024","unstructured":"Moreno-Torres V, Mart\u00ednez-Urbistondo M, del Dur\u00e1n- Campo P et al (2024) Sarcoidosis and lymphoma mortality risk: an observational study from the Spanish National Registry. J Transl Autoimmun 8:100236. https:\/\/doi.org\/10.1016\/j.jtauto.2024.100236","journal-title":"J Transl Autoimmun"},{"key":"4221_CR7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151940","volume":"11","author":"S Pohle","year":"2016","unstructured":"Pohle S, Baty F, Brutsche M (2016) In-hospital disease burden of sarcoidosis in Switzerland from 2002 to 2012. PLoS ONE 11:e0151940. https:\/\/doi.org\/10.1371\/journal.pone.0151940","journal-title":"PLoS ONE"},{"key":"4221_CR8","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373\u2013383. https:\/\/doi.org\/10.1016\/0021-9681(87)90171-8","journal-title":"J Chronic Dis"},{"key":"4221_CR9","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007844","author":"N Patel","year":"2018","unstructured":"Patel N, Kalra R, Doshi R et al (2018) Hospitalization rates, prevalence of cardiovascular manifestations, and outcomes associated with sarcoidosis in the United States. J Am Heart Assoc. https:\/\/doi.org\/10.1161\/JAHA.117.007844","journal-title":"J Am Heart Assoc"},{"key":"4221_CR10","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/1471-2466-12-19","volume":"12","author":"AK Gerke","year":"2012","unstructured":"Gerke AK, Yang M, Tang F et al (2012) Increased hospitalizations among sarcoidosis patients from 1998 to 2008: a population-based cohort study. BMC Pulm Med 12:19. https:\/\/doi.org\/10.1186\/1471-2466-12-19","journal-title":"BMC Pulm Med"},{"key":"4221_CR11","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1513\/AnnalsATS.201610-750OC","volume":"14","author":"P Ungprasert","year":"2017","unstructured":"Ungprasert P, Crowson CS, Matteson EL (2017) Sarcoidosis increases risk of hospitalized infection. A population-based study, 1976\u20132013. Ann Am Thorac Soc 14:676\u2013681. https:\/\/doi.org\/10.1513\/AnnalsATS.201610-750OC","journal-title":"Ann Am Thorac Soc"},{"key":"4221_CR12","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.1164\/rccm.201010-1679OC","volume":"183","author":"JJ Swigris","year":"2011","unstructured":"Swigris JJ, Olson AL, Huie TJ et al (2011) Sarcoidosis-related mortality in the United States from 1988 to 2007. Am J Respir Crit Care Med 183:1524\u20131530. https:\/\/doi.org\/10.1164\/rccm.201010-1679OC","journal-title":"Am J Respir Crit Care Med"},{"key":"4221_CR13","doi-asserted-by":"publisher","first-page":"1701815","DOI":"10.1183\/13993003.01815-2017","volume":"51","author":"M Rossides","year":"2018","unstructured":"Rossides M, Kullberg S, Askling J et al (2018) Sarcoidosis mortality in Sweden: a population-based cohort study. Eur Respir J 51:1701815. https:\/\/doi.org\/10.1183\/13993003.01815-2017","journal-title":"Eur Respir J"},{"key":"4221_CR14","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1378\/chest.11-0324","volume":"140","author":"JJ Swigris","year":"2011","unstructured":"Swigris JJ, Olson AL, Huie TJ et al (2011) Increased risk of pulmonary embolism among US decedents with sarcoidosis from 1988 to 2007. Chest 140:1261\u20131266. https:\/\/doi.org\/10.1378\/chest.11-0324","journal-title":"Chest"},{"key":"4221_CR15","doi-asserted-by":"publisher","first-page":"2000767","DOI":"10.1183\/13993003.00767-2020","volume":"56","author":"M Rossides","year":"2020","unstructured":"Rossides M, Kullberg S, Eklund A et al (2020) Risk of first and recurrent serious infection in sarcoidosis: a Swedish register-based cohort study. Eur Respir J 56:2000767. https:\/\/doi.org\/10.1183\/13993003.00767-2020","journal-title":"Eur Respir J"},{"key":"4221_CR16","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1084\/jem.20050648","volume":"203","author":"M Miyara","year":"2006","unstructured":"Miyara M, Amoura Z, Parizot C et al (2006) The immune paradox of sarcoidosis and regulatory T cells. J Exp Med 203:359\u2013370. https:\/\/doi.org\/10.1084\/jem.20050648","journal-title":"J Exp Med"},{"key":"4221_CR17","doi-asserted-by":"publisher","first-page":"87","DOI":"10.36141\/svdld.v37i2.9599","volume":"37","author":"H Syed","year":"2020","unstructured":"Syed H, Ascoli C, Linssen CF et al (2020) Infection prevention in sarcoidosis: proposal for vaccination and prophylactic therapy. Sarcoidosis Vasc Diffuse Lung Dis 37:87\u201398. https:\/\/doi.org\/10.36141\/svdld.v37i2.9599","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"key":"4221_CR18","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10215067","volume":"10","author":"T Gonen","year":"2021","unstructured":"Gonen T, Katz-Talmor D, Amital H et al (2021) The association between sarcoidosis and ischemic heart disease\u2014a healthcare analysis of a large Israeli population. J Clin Med 10:5067. https:\/\/doi.org\/10.3390\/jcm10215067","journal-title":"J Clin Med"},{"key":"4221_CR19","doi-asserted-by":"publisher","first-page":"1601290","DOI":"10.1183\/13993003.01290-2016","volume":"49","author":"P Ungprasert","year":"2017","unstructured":"Ungprasert P, Crowson CS, Matteson EL (2017) Risk of cardiovascular disease among patients with sarcoidosis: a population-based retrospective cohort study, 1976\u20132013. Eur Respir J 49:1601290. https:\/\/doi.org\/10.1183\/13993003.01290-2016","journal-title":"Eur Respir J"},{"key":"4221_CR20","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1007\/s10554-020-02041-x","volume":"37","author":"Y Yilmaz","year":"2021","unstructured":"Yilmaz Y, Kul S, Kavas M et al (2021) Is there an association between sarcoidosis and atherosclerosis? Int J Cardiovasc Imaging 37:559\u2013567. https:\/\/doi.org\/10.1007\/s10554-020-02041-x","journal-title":"Int J Cardiovasc Imaging"},{"key":"4221_CR21","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1378\/chest.14-1475","volume":"147","author":"M Bonifazi","year":"2015","unstructured":"Bonifazi M, Bravi F, Gasparini S et al (2015) Sarcoidosis and cancer risk. Chest 147:778\u2013791. https:\/\/doi.org\/10.1378\/chest.14-1475","journal-title":"Chest"},{"key":"4221_CR22","doi-asserted-by":"publisher","first-page":"186","DOI":"10.3899\/jrheum.210588","volume":"49","author":"M Faurschou","year":"2022","unstructured":"Faurschou M, Omland LH, Obel N et al (2022) Risk of cancer among sarcoidosis patients with biopsy-verified nonnecrotizing granulomatous inflammation: population-based cohort study. J Rheumatol 49:186\u2013191. https:\/\/doi.org\/10.3899\/jrheum.210588","journal-title":"J Rheumatol"},{"key":"4221_CR23","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1093\/postmj\/qgae045","volume":"100","author":"P Brito-Zer\u00f3n","year":"2024","unstructured":"Brito-Zer\u00f3n P, Flores-Ch\u00e1vez A, Gonz\u00e1lez-de-Paz L et al (2024) Temporal relationship between sarcoidosis and malignancies in a nationwide cohort of 1942 patients. Postgrad Med J 100:898\u2013907. https:\/\/doi.org\/10.1093\/postmj\/qgae045","journal-title":"Postgrad Med J"},{"key":"4221_CR24","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1093\/annonc\/mdq614","volume":"22","author":"X Shu","year":"2011","unstructured":"Shu X, Ji J, Sundquist K et al (2011) Survival in cancer patients with previous hospitalization for sarcoidosis: a Swedish population-based cohort study during 1964\u20132006. Ann Oncol 22:1427\u20131434. https:\/\/doi.org\/10.1093\/annonc\/mdq614","journal-title":"Ann Oncol"},{"key":"4221_CR25","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1177\/039463201302600204","volume":"26","author":"C Tana","year":"2013","unstructured":"Tana C, Giamberardino MA, Di Gioacchino M et al (2013) Immunopathogenesis of sarcoidosis and risk of malignancy: a lost truth? Int J Immunopathol Pharmacol 26:305\u2013313. https:\/\/doi.org\/10.1177\/039463201302600204","journal-title":"Int J Immunopathol Pharmacol"},{"key":"4221_CR26","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s10875-012-9847-0","volume":"33","author":"J Candido","year":"2013","unstructured":"Candido J, Hagemann T (2013) Cancer-related inflammation. J Clin Immunol 33:79\u201384. https:\/\/doi.org\/10.1007\/s10875-012-9847-0","journal-title":"J Clin Immunol"},{"key":"4221_CR27","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.chest.2024.01.042","volume":"166","author":"A Yafasova","year":"2024","unstructured":"Yafasova A, Fosb\u00f8l EL, Gustafsson F et al (2024) Long-term risk of VTE in sarcoidosis. Chest 166:136\u2013145. https:\/\/doi.org\/10.1016\/j.chest.2024.01.042","journal-title":"Chest"},{"key":"4221_CR28","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.chest.2016.09.009","volume":"151","author":"P Ungprasert","year":"2017","unstructured":"Ungprasert P, Crowson CS, Matteson EL (2017) Association of sarcoidosis with increased risk of VTE. Chest 151:425\u2013430. https:\/\/doi.org\/10.1016\/j.chest.2016.09.009","journal-title":"Chest"},{"key":"4221_CR29","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.25520","author":"A Kassem","year":"2022","unstructured":"Kassem A, Dahabra L, Abou Yassine A et al (2022) Association between sarcoidosis and risk of venous thromboembolism: a retrospective chart review. Cureus. https:\/\/doi.org\/10.7759\/cureus.25520","journal-title":"Cureus"},{"key":"4221_CR30","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s00408-017-0076-4","volume":"196","author":"P Brito-Zer\u00f3n","year":"2018","unstructured":"Brito-Zer\u00f3n P, Acar-Denizli N, Sis\u00f3-Almirall A et al (2018) The burden of comorbidity and complexity in sarcoidosis: impact of associated chronic diseases. Lung 196:239\u2013248. https:\/\/doi.org\/10.1007\/s00408-017-0076-4","journal-title":"Lung"}],"container-title":["Internal and Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11739-025-04221-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11739-025-04221-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11739-025-04221-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T10:00:30Z","timestamp":1775642430000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11739-025-04221-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,7]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["4221"],"URL":"https:\/\/doi.org\/10.1007\/s11739-025-04221-w","relation":{},"ISSN":["1828-0447","1970-9366"],"issn-type":[{"value":"1828-0447","type":"print"},{"value":"1970-9366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,7]]},"assertion":[{"value":"29 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study complies with the Declaration of Helsinki and was approved by the Ethics Committee of Hospital Universitario Puerta de Hierro Majadahonda-Madrid (Protocol number PI 162\/24). All data were provided anonymously after the removal of all possible patient identifiers. Due to the design of the study and in accordance with Spanish legislation, informed consent was not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}