Pulmonary and psychosocial findings at enrollment in the ACCESS study

Henry Yeager, Milton D. Rossman, Robert P. Baughman, Alvin S. Teirstein, Marc A. Judson, David L. Rabin, Michael C. Iannuzzi, Cecile Rose, Eddy A. Bresnitz, Louis DePalo, Gary Hunninghake, Carol J. Johns, Geoffrey McLennan, David R. Moller, Lee S. Newman, Benjamin Rybicki, Steven E. Weinberger, Patricia C. Wilkins, Rueben Cherniack

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


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 ≥ 40, African-American race, body mass index ≥ 30kg/m 2, 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.

Original languageEnglish (US)
Pages (from-to)147-153
Number of pages7
JournalSarcoidosis Vasculitis and Diffuse Lung Diseases
Issue number2
StatePublished - Jun 1 2005


  • Health-related quality of life
  • Pulmonary disease
  • Sarcoidosis

ASJC Scopus subject areas

  • Internal Medicine
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine


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