Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio.
J Am Acad Dermatol. 2018 Oct;79(4):659-663.e2. doi: 10.1016/j.jaad.2018.02.007. Epub 2018 Feb 10.
Whether the underlying disease affects the outcomes in pyoderma gangrenosum (PG) is unclear.
To determine the impact of comorbid disease associations and concomitant procedural treatments on patient outcomes in hospitalizations of patients with PG.
A cross-sectional analysis of the National Inpatient Sample for hospitalizations of patients with PG from the years 2002 to 2011, analyzing in-hospital mortality rate and health care resource utilization.
Inflammatory bowel disease was the most frequent comorbid association, followed by inflammatory arthritis, hematologic malignancies/dyscrasia, and vasculitis. Multivariable modeling showed that vasculitis and hematologic malignancy/dyscrasia, when compared with inflammatory bowel disease, were associated with a 4-fold to 6-fold increased risk of in-hospital mortality and increasing health care resource utilization. Inpatient procedural interventions, including skin grafts, biopsies, and debridement, did not affect mortality and were associated with an increased length of stay.
The database does not account for outpatient follow-up; additionally, there was a low rate of coded comorbid conditions.
Comprehensive evaluation to determine the underlying comorbidity for patients with PG is important for patient risk stratification.
潜在疾病是否会影响坏疽性脓皮病（PG）的结局尚不清楚。
确定合并疾病关联和伴随程序治疗对 PG 住院患者的预后的影响。
对 2002 年至 2011 年国家住院患者样本中 PG 住院患者进行横断面分析，分析住院死亡率和医疗资源利用情况。
炎症性肠病是最常见的合并症关联，其次是炎症性关节炎、血液系统恶性肿瘤/血液系统疾病和血管炎。多变量模型显示，与炎症性肠病相比，血管炎和血液系统恶性肿瘤/血液系统疾病与住院死亡率增加 4 倍至 6 倍以及医疗资源利用增加相关。包括皮肤移植、活检和清创术在内的住院程序干预措施并不影响死亡率，反而与住院时间延长有关。
该数据库未考虑门诊随访；此外，合并症的编码率较低。
全面评估 PG 患者的潜在合并症对于患者的风险分层很重要。
