{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:57:32Z","timestamp":1772931452439,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Sarcoidosis, marked by chronic inflammation and granuloma formation, shows a variable clinical course. While many patients have benign outcomes, others face chronic, life-threatening complications. Mortality studies in sarcoidosis show mixed results due to age, ethnicity, sex, and geography, highlighting the need for a comprehensive mortality risk analysis. This study compares mortality risks between sarcoidosis patients and controls, considering demographic and clinical factors, and performs subgroup analyses across different age groups and post-diagnosis periods. Materials and Methods: This is a retrospective cohort study that used Clalit Health Services\u2019 electronic database, including patients first diagnosed with sarcoidosis from 2000 to 2016 and age- and sex-matched controls at a 1:5 ratio. Hazard ratios (HR) for all-cause mortality were obtained using the Cox proportional hazard model, adjusted for sociodemographic and clinical variables. Results: Sarcoidosis patients showed higher mortality rates (17.7%) than controls (10.6%), with an adjusted HR of 1.79 (95% CI: 1.64\u20131.96, p &lt; 0.001). Subgroup analysis revealed the HR for mortality decreased with age: HR for patients under 50 was 3.04 (95% CI: 2.20\u20134.21), and for those over 70, it was 1.8 (95% CI: 1.69\u20132.11). The HR was highest in the first year post-diagnosis. Key mortality predictors included age at diagnosis, male gender, and higher Charlson comorbidity index score. Conclusions: Sarcoidosis patients, particularly younger ones and those with higher comorbidity burdens, have elevated mortality risks compared to controls, with the highest HR in the first year post-diagnosis. These findings highlight the most vulnerable period of the disease.<\/jats:p>","DOI":"10.3390\/medicina60111787","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T04:59:54Z","timestamp":1730437194000},"page":"1787","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Elevated Mortality Risk in the First Year Post-Diagnosis of Sarcoidosis: A Comprehensive Population-Based Cohort Study"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-1729","authenticated-orcid":false,"given":"Yonatan Shneor","family":"Patt","sequence":"first","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-3313","authenticated-orcid":false,"given":"Kassem","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"},{"name":"Department of Gastroenterology, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0075-5895","authenticated-orcid":false,"given":"Paula","family":"David","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3806-7529","authenticated-orcid":false,"given":"Or","family":"Hen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"},{"name":"Department of Internal Medicine C, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Gendelman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5285-6695","authenticated-orcid":false,"given":"Yoav","family":"Elizur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0394-0323","authenticated-orcid":false,"given":"Basel","family":"Ahmaro","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orly","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Hospital Division, Clalit Health Services, Tel Aviv 67754, Israel"},{"name":"Department of Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-8027","authenticated-orcid":false,"given":"Abdulla","family":"Watad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"},{"name":"NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton, Leeds Teaching Hospital Trust, Leeds LS1 3EX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-7716","authenticated-orcid":false,"given":"Howard","family":"Amital","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4721-2003","authenticated-orcid":false,"given":"Niv","family":"Ben-Shabat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1056\/NEJMra071714","article-title":"Sarcoidosis","volume":"357","author":"Iannuzzi","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"103247","DOI":"10.1016\/j.jaut.2024.103247","article-title":"The immunopathogenesis of sarcoidosis","volume":"10","author":"Miedema","year":"2024","journal-title":"J. Autoimmun."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/S0140-6736(13)60680-7","article-title":"Sarcoidosis","volume":"383","author":"Valeyre","year":"2014","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/s41572-019-0096-x","article-title":"Sarcoidosis","volume":"5","author":"Grunewald","year":"2019","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/MCP.0000000000000080","article-title":"Morbidity and mortality in sarcoidosis","volume":"20","author":"Gerke","year":"2014","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_6","first-page":"128","article-title":"Mortality among African American women with sarcoidosis: Data from the Black Women\u2019s Health Study","volume":"30","author":"Tukey","year":"2013","journal-title":"Sarcoidosis Vasc. Diffus. Lung Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1183\/09031936.00187410","article-title":"Stage IV sarcoidosis: Comparison of survival with the general population and causes of death","volume":"38","author":"Nardi","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/S0002-9343(97)89518-6","article-title":"Sarcoidosis mortality in the United States 1979\u20131991: An analysis of multiple-cause mortality data","volume":"100","author":"Gideon","year":"1996","journal-title":"Am. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1056\/NEJMra2101555","article-title":"Challenges of Sarcoidosis and Its Management","volume":"385","author":"Drent","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lee, Y.C., Chang, K.Y., and Mirsaeidi, M. (2021). State-level health disparity is associated with sarcoidosis mortality. J. Clin. Med., 10.","DOI":"10.3390\/jcm10112366"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/crj.12398","article-title":"The influence of comorbidities on mortality in sarcoidosis: A observational prospective cohort study","volume":"11","author":"Goljan","year":"2017","journal-title":"Clin. Respir J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.chest.2017.07.008","article-title":"Predictors of Mortality in Pulmonary Sarcoidosis","volume":"153","author":"Kirkil","year":"2018","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Z\u00f6ller, B., Li, X., Sundquist, J., and Sundquist, K. (2012). Risk of subsequent coronary heart disease in patients hospitalized for immune-mediated diseases: A nationwide follow-up study from Sweden. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0033442"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1183\/09031936.00084414","article-title":"Sarcoidosis and subsequent cancer risk: A Danish nationwide cohort study","volume":"45","author":"Thomsen","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s00408-017-0015-4","article-title":"Sarcoidosis in Israel: Clinical Outcome Status, Organ Involvement, and Long-Term Follow-Up","volume":"195","author":"Markevitz","year":"2017","journal-title":"Lung"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1093\/postmj\/qgad045","article-title":"Ankylosing spondylitis is associated with increased prevalence of valvular heart diseases: A cross-sectional population-based study","volume":"99","author":"Eid","year":"2023","journal-title":"Postgrad. Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1093\/rheumatology\/kead526","article-title":"Increased risk of osteoporosis and femoral neck fractures in patients with familial Mediterranean fever-a large retrospective cohort study","volume":"63","author":"Patt","year":"2024","journal-title":"Rheumatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1111\/resp.12369","article-title":"Is the incidence of malignancy increased in patients with sarcoidosis? A systematic review and meta-analysis","volume":"19","author":"Ungprasert","year":"2014","journal-title":"Respirology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1093\/annonc\/mdn767","article-title":"Cancer risk in hospitalized sarcoidosis patients: A follow-up study in Sweden","volume":"20","author":"Ji","year":"2009","journal-title":"Ann. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1136\/thx.2006.062836","article-title":"Incidence and mortality of idiopathic pulmonary fibrosis and sarcoidosis in the UK","volume":"61","author":"Gribbin","year":"2006","journal-title":"Thorax"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1701815","DOI":"10.1183\/13993003.01815-2017","article-title":"Sarcoidosis mortality in Sweden: A population-based cohort study","volume":"51","author":"Rossides","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1183\/09031936.93.06030349","article-title":"Vital prognosis in intrathoracic sarcoidosis with special reference to pulmonary function and radiological stage","volume":"6","author":"Viskum","year":"1993","journal-title":"Eur. Respir. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.mayocp.2015.10.024","article-title":"Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study","volume":"91","author":"Ungprasert","year":"2016","journal-title":"Mayo Clin. Proc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1183\/13993003.00457-2016","article-title":"Sarcoidosis-related mortality in France: A multiple-cause-of-death analysis","volume":"48","author":"Jamilloux","year":"2016","journal-title":"Eur. Respir J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/resp.14202","article-title":"Sarcoidosis-related mortality and the impact of corticosteroid treatment: A population-based cohort study","volume":"27","author":"Sikjaer","year":"2022","journal-title":"Respirology"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gonen, T., Katz-Talmor, D., Amital, H., Comaneshter, D., Cohen, A.D., and Tiosano, S. (2021). The Association between Sarcoidosis and Ischemic Heart Disease-A Healthcare Analysis of a Large Israeli Population. J. Clin. Med., 10.","DOI":"10.3390\/jcm10215067"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/joim.13629","article-title":"Sarcoidosis: Epidemiology and clinical insights","volume":"293","author":"Rossides","year":"2023","journal-title":"J. Intern. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/qjmed\/hcz207","article-title":"Paraneoplastic sarcoidosis: A review","volume":"113","author":"Herron","year":"2020","journal-title":"QJM"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/0305-7372(86)90002-2","article-title":"Sarcoid reactions in malignant tumours","volume":"13","author":"Brincker","year":"1986","journal-title":"Cancer Treat. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"S\u00e8ve, P., Pacheco, Y., Durupt, F., Jamilloux, Y., Gerfaud-Valentin, M., Isaac, S., Boussel, L., Calender, A., Androdias, G., and Valeyre, D. (2021). Sarcoidosis: A Clinical Overview from Symptoms to Diagnosis. Cells, 10.","DOI":"10.3390\/cells10040766"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1097\/MCP.0000000000000077","article-title":"Clinical phenotypes in sarcoidosis","volume":"20","author":"Pereira","year":"2014","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"106828","DOI":"10.1016\/j.rmed.2022.106828","article-title":"Trends in sarcoidosis mortality rate in Japan from 2001 to 2020: A population-based study","volume":"196","author":"Harada","year":"2022","journal-title":"Respir. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1164\/rccm.201010-1679OC","article-title":"Sarcoidosis-related mortality in the United States from 1988 to 2007","volume":"183","author":"Swigris","year":"2011","journal-title":"Am. J. Respir. Crit. Care. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1016\/j.rmed.2018.03.028","article-title":"Prevalence, incidence, and mortality of sarcoidosis in Korea, 2003\u20132015: A nationwide population-based study","volume":"144S","author":"Park","year":"2018","journal-title":"Respir. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1136\/heartjnl-2013-304588","article-title":"Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002\u20132012","volume":"100","author":"Radovanovic","year":"2013","journal-title":"Heart"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e054058","DOI":"10.1136\/bmjopen-2021-054058","article-title":"Validation and adaptation of the Charlson Comorbidity Index using administrative data from the Colombian health system: Retrospective cohort study","volume":"12","author":"Oliveros","year":"2022","journal-title":"BMJ Open"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000521288","article-title":"Charlson Comorbidity Index: A Critical Review of Clinimetric Properties","volume":"91","author":"Charlson","year":"2022","journal-title":"Psychother. Psychosom."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/2040622318790197","article-title":"Epidemiology of sarcoidosis: Current findings and future directions","volume":"9","author":"Arkema","year":"2018","journal-title":"Ther. Adv. Chronic. Dis."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/11\/1787\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:26:25Z","timestamp":1760113585000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/11\/1787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":38,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["medicina60111787"],"URL":"https:\/\/doi.org\/10.3390\/medicina60111787","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,1]]}}}