Introduction: Neurosarcoidosis (NS) occurs in approximately 5-26% of sarcoid patients and 50-70% present with a neurological concern as their chief complaint. This underscores the importance of diagnostic vigilance for sarcoidosis even in patients without obvious systemic disease.

Objectives: Compare hospital admission rates, resource utilization, and post-discharge outcomes among patients with NS and those with systemic sarcoidosis over a ten-year period.

Materials and Methods: IRB approved retrospective study of electronic medical record information July 2013 to June 2023 at a tertiary care enter.

Results: 2357 patients with sarcoidosis were identified. 184 (8%) received outpatient neurology evaluation and are considered NS. 96 (52%) were admitted for any reason over the course of the decade. 930 (39%) of those not receiving neurological follow up, sarcoid cohort (S), were admitted for any reason over the course of the decade.

64% of NS patients receiving corticosteroid therapy had an admission, with 70% of those on mycophenolate being admitted, and 80% of those on infliximab, compared to 49%, 70%, and 60% for S patients, respectively.

50% of NS patients stayed between 1-2 days, compared to 56% of S patients, with similar trends across longer admissions. 22 (23%) of NS patients were discharged to SNF, 15 (15.6%) to AIR, and 3 (3%) expired, vs 134 (14%) 82 (9%), 70 (8.5%) for S patients respectively.

79/96 (82%) of these admitted patients were seen in an outpatient neurology setting within 6 months of discharge.

Conclusions: Post-admission data is similar between groups within limitations of the sample. Patients referred to neurology clinic are more likely to have a recent admission than general sarcoid population (OR 1.67 [1.26-2.20], p<0.05).

NS often mimics disabling or life-threatening conditions necessitating the increased time and resource availability of inpatient workup. This underscores the diagnostic difficulties associated with assessing for neurological involvement of sarcoidosis.