Pulmonary and psychosocial findings at enrollment in the ACCESS study.

Pubmed ID: 16053031

Journal: Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG

Publication Date: June 1, 2005

MeSH Terms: Humans, Male, Adult, Female, Case-Control Studies, United States, Prognosis, Severity of Illness Index, Quality of Life, Incidence, Predictive Value of Tests, Spirometry, Depression, Sarcoidosis, Pulmonary, Dyspnea, Biopsy, Psychological Tests, Radiography, Thoracic, Surveys and Questionnaires, Black or African American

Grants: N01-HR-56065, N01-HR-56068, N01-HR-56069, N01-HR-56070, N01-HR-56071, N01-HR-56072, N01-HR-56073, N01-HR-56074, N01-HR-56075

Authors: Yeager H, Rossman MD, Baughman RP, Teirstein AS, Judson MA, Rabin DL, Iannuzzi MC, Rose C, Bresnitz EA, DePalo L, Hunninghakes G, Johns CJ, McLennan G, Moller DR, Newman LS, Rybicki B, Weinberger SE, Wilkins PC, Cherniack R

Cite As: Yeager H, Rossman MD, Baughman RP, Teirstein AS, Judson MA, Rabin DL, Iannuzzi MC, Rose C, Bresnitz EA, DePalo L, Hunninghakes G, Johns CJ, McLennan G, Moller DR, Newman LS, Rybicki B, Weinberger SE, Wilkins PC, Cherniack R, ACCESS Research Group. Pulmonary and psychosocial findings at enrollment in the ACCESS study. Sarcoidosis Vasc Diffuse Lung Dis 2005 Jun;22(2):147-53.

Studies:

A Case Controlled Etiologic Study of Sarcoidosis (ACCESS)

Abstract

AIM: To assess lung involvement and the association of demographic and psychosocial factors with respiratory health in 736 persons with sarcoidosis at enrollment in A Case Control Etiologic Study of Sarcoidosis (ACCESS). METHODS: 736 patients with biopsy diagnosis of sarcoidosis within 6 months of enrollment were studied at 10 US centers. Lung involvement was evaluated by chest radiography, spirometry and dyspnea questionnaire. Demographics, number of involved extrathoracic organ systems, comorbidities, and health-related quality of life (HRQL) were assessed. RESULTS: 95% of patients had lung involvement. 8% were Scadding Stage 0, 40% I, 37% II, 10% III, and 5% IV 51% reported dyspnea. Increasing radiographic lung stage was associated with decreasing Forced Vital Capacity (FVC) (p < 0.01). Patients with higher stages had more airways obstruction and dyspnea. 46% of cases and 27% of controls had Center for Epidemiologic Studies Depression Scale (CES-D) scores of 9 or greater, (p < 0.001). Age > or = 40, African-American race, body mass index > or = 30kg/m2, and CES-D scores > 9 were associated with decreased FVC and greater dyspnea. Impaired spirometry and greater dyspnea were associated with poorer quality of life. CONCLUSION: A "global" approach to the sarcoidosis patient, including careful assessment of dyspnea and health related quality of life, as well as of lung function and radiographic changes, and any extrathoracic involvement, is important, not only in management of the individual patient, but should also prove beneficial in assessing outcomes in clinical trials in the future.