title: Sarcoidosis in the national veteran population: association of ocular inflammation and mortality.
abstract: OBJECTIVE
  To describe the distribution of ocular sarcoidosis in the veteran population and to determine the association between ocular disease and all-cause mortality.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  The Veterans Health Administration National Patient Care Database information on medical diagnoses, date of diagnosis, age, race, gender, and Veterans Administration medical center station number for site-specific calculations for fiscal years 2010 through 2012 was collected. Mortality data were obtained from the Beneficiary Identification Records Locator Subsystem. The patient cohort was identified with a primary diagnosis of sarcoidosis using International Classification of Disease, ninth edition, code of 135 in outpatient treatment files for the study period. The sarcoidosis patients were divided into those with uveitis or orbital inflammation (defined as ocular inflammation for this study) and those without uveitis or orbital inflammation. Survival analysis was performed using the Cox proportional hazard method.
  
  
  METHODS
  Association between ocular inflammation and 1-year mortality.
  
  
  RESULTS
  Of 15 130 subjects with sarcoidosis, 3364 (22.2%) were evaluated in an eye clinic within a Veterans Administration Medical Center. Most patients were diagnosed with anterior uveitis (n = 1013; 80.7% of ocular inflammation), and the least common diagnosis was orbital granuloma (n = 28; 2.2% of ocular inflammation). Male gender was protective to the development of uveitis (estimate, 0.76; 95% confidence interval, 0.65-0.88; P = 0.0005). The overall 1-year all-cause mortality for all patients with a diagnosis of sarcoidosis was 2.0%. Ocular inflammation was associated with a decrease in 1-year all-cause mortality (simple model: hazard ratio, 0.36; P = 0.0015; complex model: hazard ratio, 0.35; P = 0.013).
  
  
  CONCLUSIONS
  Veterans with ocular inflammation had significantly lower 1-year all-cause mortality than those without documented ocular inflammation. The reason for this finding remains to be established.
authors: Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Health Services Research and Development, Veterans Administration, Chicago, Illinois. Electronic address: andrea.birnbaum@va.gov.
authors: Andrea D
authors: AD
authors: Birnbaum
authors: Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Health Services Research and Development, Veterans Administration, Chicago, Illinois.
authors: Dustin D
authors: DD
authors: French
authors: Section of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors: Mehdi
authors: M
authors: Mirsaeidi
authors: Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors: Sarah
authors: S
authors: Wehrli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002833:Choroiditis / Q000453:epidemiology*; D005128:Eye Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012173:Retinitis / Q000453:epidemiology*; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014605:Uveitis / Q000453:epidemiology*; D014728:Veterans / Q000706:statistics & numerical data*; D058014:Veterans Health / Q000706:statistics & numerical data; D055815:Young Adult