Sex, race, and ethnic disparities in sarcoidosis-related mortality in the united states

SESSION TITLE: Diffuse Lung Disease Posters 6 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: Sarcoidosis is a multisystem granulomatous disease with unknown etiology. However, previous studies have alluded to race and ethnicity's vital role in sarcoidosis epidemiology, disease presentation, and clinical outcomes. In this study, we examined the trend of sarcoidosis-related mortality and their differences across sex, race, and ethnicity. METHODS: We investigated sarcoidosis-associated mortality from 1999-2020 using CDC WONDER multiple cause of death (MCOD) datafiles. Age-standardized mortality rates (ASMRs) per million population were identified with ICD code D86 and were stratified by sex, race, ethnicity, and age groups. Joinpoint regression analysis was performed to report time trends, average annual percentage change (AAPC), and p-value. RESULTS: Over the study period, sarcoidosis-associated deaths occurred in 37,956 individuals including 15,247 (40%) males, and 22709 (60%) females. Of those, 19,521 (51%) were African American and 18,038 (48%) were White. The average ASMR was 5.19 (CI, 5.14 - 5.24) per million population. A higher mortality burden was observed in females [5.72 (5.64 - 5.79)] in comparison to males [4.49 (4.42 - 4.56)]. Significant racial and ethnic disparities were identified with ASMRs of 2.87 (2.83 - 2.92) in Whites, 23.84 (23.5 - 24.18) in African Americans, 2.07 (1.69 - 2.45) in American Indians/Alaska Natives, 0.85 (0.74 - 0.95) in Asian/Pacific Islanders, 5.58 (5.53 - 5.64) in non-Hispanics, and 1.65 (1.54 - 1.75) in Hispanics. By age group, African American population reached a peak mortality rate in the 65 to 74 years (71.97 [69.61 - 74.33]) in comparison to the 85+ age group in the White population (17.64, [16.84 - 18.44]) indicating poor survival in the former. From 1999 through 2020, sarcoidosis-associated ASMR increased from 3.9 (3.67 - 4.14) to 6.42 (6.17 - 6.68) (AAPC, 2.1% [1.3 – 3]; p=0.001). A faster rise was recorded in males with a change in ASMR from 3.24 (2.93 - 3.56) to 6.10 (5.74 - 6.46) [AAPC, 2.1% (1.8 - 2.5); p=0.001)] n comparison to females with an increase from 4.44 (4.10 - 4.78) to 6.59 (6.24 - 6.94) [AAPC, 1.7% (0.6 – 2.8); p=0.003]. The mortality rate among Whites doubled from 1.85 (1.68 - 2.02) to 3.81 (3.6 - 4.02) [AAPC, 2.9% (2.1- 3.8); p= 0.001] and the rise was slow among Blacks from 21.08 (19.4 - 22.76) to 27.2 (25.67 - 28.74) with AAPC of 1% (-0.5 – 2.4) without reaching statistical significance (p=0.199). CONCLUSIONS: Race and sex play a significant role as a determinant of health in the United States. We found a sobering race, gender, and ethnicity-related difference within sarcoidosis-related mortality, especially among the African American population, which has an eight times higher sarcoidosis mortality rate at dies earlier ages than the White population. CLINICAL IMPLICATIONS: This disparity highlights the need to address health inequalities by race and gender. DISCLOSURES: No relevant relationships by Padmanabh Bhatt No relevant relationships by Huzaifa Ahmad Cheema No relevant relationships by Chinmay Jani No relevant relationships by Dominic Marshall No relevant relationships by Preya Patel No relevant relationships by Justin Salciccioli No relevant relationships by Joseph Shalhoub No relevant relationships by Harpreet Singh No relevant relationships by Khezar Syed Consultant relationship with Median Technology Please note: 7/1/2022 Added 03/31/2023 by Carey Thomson, source=Web Response, value=Consulting fee My spouse/partner as a Stock own relationship with Fulcrum Therapeutics Please note: current Added 03/31/2023 by Carey Thomson, source=Web Response, value=stock author asthma card relationship with UpToDate Please note: current Added 03/31/2023 by Carey Thomson, source=Web Response, value=Royalty Editorial fee relationship with Springer Book - lung cancer screening Please note: 9/1/2022 Added 03/31/2023 by Carey Thomson, source=Web Response, value=Consulting fee