TY - JOUR
T1 - Hospitalization, inpatient burden and comorbidities associated with bullous pemphigoid in the U.S.A.
AU - Ren, Z.
AU - Hsu, D. Y.
AU - Brieva, J.
AU - Silverberg, N. B.
AU - Langan, S. M.
AU - Silverberg, Jonathan I
N1 - Funding Information:
The 2002–2012 National Inpatient Sample (NIS) provided by the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ) was analysed. Each year of NIS contains an approximately 20% stratified representative sample of all inpatient hospitalizations in the U.S.A. Sample weights were created by NIS that factored the sampling design of hospitals in the U.S.A. These sample weights were needed to provide representative estimates of hospital discharges across the whole country. All data were deidentified and no attempts were made to identify any of the individuals in the database. Patient consent was not obtained as the databases were received deidentified. All parties with access to the HCUP were compliant to its formal data use agreement. Approval by the Northwestern University institutional review board was waived. The 2002–2012 National Inpatient Sample (NIS) provided by the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ) was analysed. Each year of NIS contains an approximately 20% stratified representative sample of all inpatient hospitalizations in the U.S.A. Sample weights were created by NIS that factored the sampling design of hospitals in the U.S.A. These sample weights were needed to provide representative estimates of hospital discharges across the whole country. All data were deidentified and no attempts were made to identify any of the individuals in the database. Patient consent was not obtained as the databases were received deidentified. All parties with access to the HCUP were compliant to its formal data use agreement. Approval by the Northwestern University institutional review board was waived.
Publisher Copyright:
© 2016 British Association of Dermatologists
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Bullous pemphigoid (BP) is associated with significant disability and comorbid health disorders that may lead to or result from hospitalization. However, little is known about the inpatient burden and comorbidities of BP. Objectives: To obtain data on the inpatient burden and comorbidities of BP in the U.S.A. Methods: We analysed data from the 2002 to 2012 National Inpatient Sample, including a representative 20% sample of all hospitalizations in the U.S.A. (72 108 077 adults). Results: The prevalence of hospitalization for BP increased from 25·84 to 32·60 cases per million inpatients from 2002 to 2012. In multivariate logistic regression models with stepwise selection, increasing age, nonwhite ethnicity, higher median household income, being insured with Medicare or Medicaid, and increasing number of chronic conditions were all associated with hospitalization for BP (P < 0·05 for all). The top three primary discharge diagnoses for patients with a secondary diagnosis of BP were septicaemia (prevalence 5·51%, 95% confidence interval 5·03–5·99), pneumonia (4·60%, 4·19–5·01) and urinary tract infection (3·52%, 3·15–3·89). Patients with BP also had numerous autoimmune, infectious, cardiovascular and other comorbidities. Interestingly, BP was associated with multiple neuropsychiatric disorders, including demyelinating disorders, dementias (presenile, senile, vascular and other), paralysis, neuropathy (diabetic, other polyneuropathy), Parkinson disease, epilepsy, psychoses and depression. The mean annual age- and sex-adjusted in-hospital mortality rate was significantly higher in patients with a secondary diagnosis of BP compared with no BP (2·9%, range 2·8–3·9% vs. 2·1%, range 1·9–2·2%). Significant predictors of mortality in patients with BP included increasing age, nonwhite ethnicity and insurance with Medicaid or other payment status (P < 0·05 for all). Conclusions: Hospitalization for BP increased significantly between 2002 and 2012. Moreover, there were significant ethnic and healthcare disparities with respect to hospitalization and inpatient mortality from BP.
AB - Background: Bullous pemphigoid (BP) is associated with significant disability and comorbid health disorders that may lead to or result from hospitalization. However, little is known about the inpatient burden and comorbidities of BP. Objectives: To obtain data on the inpatient burden and comorbidities of BP in the U.S.A. Methods: We analysed data from the 2002 to 2012 National Inpatient Sample, including a representative 20% sample of all hospitalizations in the U.S.A. (72 108 077 adults). Results: The prevalence of hospitalization for BP increased from 25·84 to 32·60 cases per million inpatients from 2002 to 2012. In multivariate logistic regression models with stepwise selection, increasing age, nonwhite ethnicity, higher median household income, being insured with Medicare or Medicaid, and increasing number of chronic conditions were all associated with hospitalization for BP (P < 0·05 for all). The top three primary discharge diagnoses for patients with a secondary diagnosis of BP were septicaemia (prevalence 5·51%, 95% confidence interval 5·03–5·99), pneumonia (4·60%, 4·19–5·01) and urinary tract infection (3·52%, 3·15–3·89). Patients with BP also had numerous autoimmune, infectious, cardiovascular and other comorbidities. Interestingly, BP was associated with multiple neuropsychiatric disorders, including demyelinating disorders, dementias (presenile, senile, vascular and other), paralysis, neuropathy (diabetic, other polyneuropathy), Parkinson disease, epilepsy, psychoses and depression. The mean annual age- and sex-adjusted in-hospital mortality rate was significantly higher in patients with a secondary diagnosis of BP compared with no BP (2·9%, range 2·8–3·9% vs. 2·1%, range 1·9–2·2%). Significant predictors of mortality in patients with BP included increasing age, nonwhite ethnicity and insurance with Medicaid or other payment status (P < 0·05 for all). Conclusions: Hospitalization for BP increased significantly between 2002 and 2012. Moreover, there were significant ethnic and healthcare disparities with respect to hospitalization and inpatient mortality from BP.
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U2 - 10.1111/bjd.14821
DO - 10.1111/bjd.14821
M3 - Article
C2 - 27343837
AN - SCOPUS:85010272639
SN - 0007-0963
VL - 176
SP - 87
EP - 99
JO - British Journal of Dermatology
JF - British Journal of Dermatology
IS - 1
ER -
