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Serious infection prevalence higher for inpatients with psoriasis vs. those without

Serious infections were significantly higher in prevalence and increasing in incidence among inpatients in the United States with psoriasis compared with those without psoriasis, according to recently published study results.

Jonathan I. Silverberg, MD, PhD, MPH, of the department of dermatology, Northwestern University Feinberg School of Medicine, and colleagues conducted a cross-sectional study of the Nationwide Inpatient Sample from 2002 to 2012, containing a representative 20% stratified representative sample of all hospitalizations in the United States. Primary and/or secondary discharge diagnosis were identified from the databases, and serious infections included those previously studied with psoriasis.

Jonathan I. Silverberg

The researchers “sought to determine rates and predictors of serious infections in hospitalized psoriasis patients and quantify costs of care, length of stay and mortality.”

Patients with psoriasis were older than patients without psoriasis (59.9 years vs. 47.9 years), while there were fewer female patients with psoriasis (47.5% vs. 58.6%). Serious infections were reported for 28.2% of hospitalizations of patients with psoriasis and 21% of hospitalizations of patients without psoriasis.

MRSA (OR = 1.76; 95% CI, 1.52-2.03), cellulitis (OR = 3.21; 95% CI, 3.12-3.3), herpes simplex virus infection (OR = 2.21; 95% CI, 1.7-2.89), infectious arthritis (OR = 1.82; 95% CI, 1.58-2.09), osteomyelitis (OR = 1.31; 95% CI, 1.18-1.46), meningitis (OR = 1.31; 95% CI, 1.16-1.47), encephalitis (OR = 1.22; 95% CI, 1.02-1.47) and tuberculosis (OR = 1.34; 95% CI, 1.2-1.49), were serious infections associated with psoriasis, according to multivariate logistic regression models.

“Among patients with psoriasis, rates of serious infections increased over all time intervals analyzed (P = .01) and were significantly higher compared with those without psoriasis across all time intervals (P < .0001),” the researchers wrote.

Patients with psoriasis and serious infections had a higher mean length of stay (6.6 days) and cost of care ($13,291) compared with patients with psoriasis without serious infections (4.6 days; $11,003; P < .0001).

“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.”  – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.