Serious infections in hospitalized patients with psoriasis in the United States. J Am Acad Dermatol 2016 Aug;75(2):287-96
Date
06/22/2016Pubmed ID
27324314DOI
10.1016/j.jaad.2016.04.005Scopus ID
2-s2.0-84992027539 (requires institutional sign-in at Scopus site) 40 CitationsAbstract
BACKGROUND: Patients with psoriasis have multiple risk factors for serious infections, including immune dysregulation, systemic immunosuppressive medications, and comorbid health conditions.
OBJECTIVE: We sought to determine rates and predictors of serious infections in hospitalized psoriasis patients and quantify costs of care, length of stay, and mortality.
METHODS: We conducted a cross-sectional study of the Nationwide Inpatient Sample from 2002 to 2012, containing a representative 20% sample of all hospitalizations in the United States.
RESULTS: In multivariate logistic regression models, psoriasis was associated with multiple serious infections, including methicillin-resistant Staphylococcus aureus (odds ratio [OR] 1.76, 95% confidence intervals [CI] 1.52-2.03), cellulitis (OR 3.21, 95% CI 3.12-3.30), herpes simplex virus infection (OR 2.21, 95% CI 1.70-2.89), infectious arthritis (OR 1.82, 95% CI 1.58-2.09), osteomyelitis (OR 1.31, 95% CI 1.18-1.46), meningitis (OR 1.31, 95% CI 1.16-1.47), encephalitis (OR 1.22, 95% CI 1.02-1.47), and tuberculosis (OR 1.34, 95% CI 1.20-1.49). Among patients with psoriasis, rates of serious infections increased over all time intervals analyzed (P = .01) and were significantly higher compared with those without psoriasis across all time intervals (P < .0001). The mean length of stay (6.6 ± 0.1 days) and cost of care ($13,291 ± $166) for psoriasis patients with serious infections was higher than that of psoriasis patients without serious infections (4.6 ± 0.03 days; $11,003 ± $96; P < .0001).
LIMITATIONS: The study was limited to inpatients. Medication data were not available.
CONCLUSION: Serious infections are increasing in incidence in US inpatients with psoriasis.
Author List
Hsu DY, Gordon K, Silverberg JIAuthor
Kenneth Brian Gordon MD Chair, Professor in the Dermatology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Age Distribution
Aged
Aged, 80 and over
Child
Child, Preschool
Cross-Sectional Studies
Female
Health Care Costs
Hospital Mortality
Hospitalization
Humans
Infant
Infant, Newborn
Inpatients
Length of Stay
Male
Middle Aged
Odds Ratio
Psoriasis
Sex Distribution
United States
Young Adult
