Researchers at Northwestern University’s Feinberg School of Medicine investigated the rates and predictors of serious infections in hospitalized patients with psoriasis and also quantified the costs of their care, length of stay, and mortality.
Their findings indicate that the incidence of serious infections is increasing among U.S. inpatients with psoriasis, which is translated into higher healthcare costs and longer hospitalizations than in patients with psoriasis but without serious infections.
The research paper, titled “Serious infections in hospitalized patients with psoriasis in the United States,” was published in the Journal of American Academy of Dermatology.
Psoriasis, a chronic inflammatory skin disease, often results in immune dysregulation, additional health conditions, and requires systemic immunosuppressive medications that tone down the overactive immune system. All these factors contribute to the increased risk of psoriatic patients for serious infections.
Researchers conducted a study to determine the incidence of serious infections in these patients, as well as predictors for the infections and how they affect the costs associated with psoriasis and overall patient clinical outcomes. They studied patients in the Nationwide Inpatient Sample from 2002 to 2012, which contains a representative 20 percent sample of all hospitalizations in the U.S.
Results indicate that psoriasis was associated with multiple serious infections, such as methicillin-resistant Staphylococcus aureus (MRSA), cellulitis, herpes simplex virus infection, infectious arthritis, osteomyelitis, meningitis, encephalitis, and tuberculosis.
Overall, serious infections were reported for 28.2 percent of hospitalizations of patients with psoriasis and 21 percent of hospitalizations of patients without psoriasis. The length of stay and cost of care for psoriasis patients with serious infectious were higher when compared to patients with psoriasis but no serious infections — 6.6 days vs. 4.6 days and $13,291 vs. $11,003, respectively.
The researchers reported some study limitations, including the inclusion of only inpatient data and no access to medication data.
“Serious infections are increasing in incidence in inpatients with psoriasis,” the researchers concluded. “In addition, patients with psoriasis have higher odds of certain infections, such as tuberculosis, meningitis, and fungal infections. Further research is needed to confirm these findings and … to develop large-scale interventions aimed at preservation.”