Abstract
Background: Little is known about the risk and predictors of autoimmune diseases in children and adults. Objective: To determine the prevalence, predictors, and excess costs of autoimmune disease in atopic dermatitis (AD) patients. Methods: Cross-sectional study of the 2002-2012 National Inpatient Sample, which includes a ∼20% sample of all US hospitalizations (n = 87,053,155 adults and children). Results: The prevalence of autoimmune disease was higher in adults with AD (7.9%, 95% confidence interval [95% CI] 7.3-8.5%) than without AD (5.7%, 95% CI 5.7%-5.8%) and higher in children with AD (2.0%, 95% CI 1.7%-2.3%) than without AD (1.0%, 95% CI 0.9%-1.1%). In multivariable logistic regression models controlling for sociodemographics, adult (adjusted odds ratio 1.45, 95% CI 1.32-1.58) and pediatric (adjusted odds ratio 2.08, 95% CI 1.73-2.50) AD were associated with any autoimmune disorder. In particular, AD was associated with 18 of 32 autoimmune disorders examined in adults and 13 of 24 examined in children, including disorders of the skin, endocrine, gastrointestinal, hematologic, and musculoskeletal systems. AD patients hospitalized with any autoimmune disorder had a higher cost of inpatient care, with $2.5-$50 million excess annual costs. Conclusions: Adults and children with AD had increased cutaneous and extracutaneous autoimmune disorders, which were associated with a considerable cost burden.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 382-389 |
| Number of pages | 8 |
| Journal | Journal of the American Academy of Dermatology |
| Volume | 80 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2019 |
Funding
A cross-sectional study of the 2002-2012 Nationwide Inpatient Sample (NIS) provided by the Healthcare Cost and Utilization Project from the Agency for Healthcare Research and Quality was performed. Each year of NIS contains a ∼20% stratified representative cross-sectional sample of US hospitalizations. Sample weights factored the sampling design of US hospitals, enabling representative estimates of hospital discharges across the United States. All data were deidentified. No attempts were made to identify any individuals in the database. All parties with access to the NIS were compliant with the formal data use agreement. The study was approved by the institutional review board at Northwestern University. Funding sources: Supported by the Agency for Healthcare Research and Quality, grant no. K12 HS023011, and the Dermatology Foundation.
Keywords
- atopic dermatitis
- autoimmune
- hospitalization
- inpatient
- systemic disorders
ASJC Scopus subject areas
- Dermatology