Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Eastern Virginia Medical School, Norfolk, VA, USA.
Clin Exp Dermatol. 2021 Oct;46(7):1236-1242. doi: 10.1111/ced.14652. Epub 2021 Jul 11.
Prurigo nodularis (PN) is associated with a variety of systemic comorbidities, including infectious diseases such as HIV and viral hepatitis. There are limited data on other infectious disease comorbidities in patients with PN.
To characterize infectious disease hospitalizations among patients with PN and the associated cost burden.
We searched the 2016-2017 National Inpatient Sample, a cross-sectional sample of 20% of all US hospitalizations, for infectious disease hospitalizations among patients with PN. Associations of PN with infections and related costs were determined using multivariable logistic and linear regression, adjusting for age, race, sex and insurance type.
PN was associated with any infection overall (OR = 2.98, 95% CI 2.49-3.56), and with HIV, cutaneous, hepatobiliary, central nervous system, bacterial, viral and fungal/parasitic infections and for sepsis. Patients with PN had a higher mean cost of care (US$11 667 vs. US$8893, P < 0.001) and length of stay (5.5 vs. 4.2 days, P < 0.001) for any infection overall and for 7 of 13 other infections. Adjusting for age, race, sex and insurance coverage, PN was associated with higher cost (+30%, 95% CI +17 to +44%) and higher length of stay (+30%, 95% CI +18 to +44%) for any infection overall, and for several specific infections. These associations remained with alternate regression models adjusting for severity of illness.
There is a high infectious disease burden among patients with PN, corresponding to higher healthcare utilization and spending. Clinicians must be aware of these associations when treating these patients with immunomodulatory drugs.
结节性痒疹（PN）与多种全身性合并症相关，包括 HIV 和病毒性肝炎等传染病。关于 PN 患者的其他传染病合并症，数据有限。
描述 PN 患者的传染病住院情况及其相关费用负担。
我们检索了 2016-2017 年全国住院患者样本，这是全美 20%住院患者的横断面样本，以确定 PN 患者的传染病住院情况。使用多变量逻辑回归和线性回归来确定 PN 与感染和相关费用之间的关联，调整了年龄、种族、性别和保险类型。
PN 与所有感染相关（OR=2.98，95%CI 2.49-3.56），与 HIV、皮肤、肝胆、中枢神经系统、细菌、病毒和真菌/寄生虫感染以及败血症相关。PN 患者的整体医疗费用（11667 美元比 8893 美元，P<0.001）和住院时间（5.5 天比 4.2 天，P<0.001）均较高，无论是否存在感染，以及在 13 种其他感染中的 7 种。在调整了年龄、种族、性别和保险范围后，PN 与所有感染的更高费用（增加 30%，95%CI 17-44%）和更长的住院时间（增加 30%，95%CI 18-44%）相关，无论是整体感染还是特定的几种感染。这些关联在调整疾病严重程度的替代回归模型中仍然存在。
PN 患者的传染病负担很高，相应地导致更高的医疗保健利用和支出。在使用免疫调节剂治疗这些患者时，临床医生必须注意到这些关联。
