Association of prurigo nodularis and infectious disease hospitalizations: a national cross-sectional study.

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 U.S. 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), as well as sepsis, HIV, cutaneous, hepatobiliary, CNS, bacterial, viral, and fungal/parasitic infections. PN patients had a higher mean cost of care ($11,667 vs. $8,893, P<0.001) and length of stay (5.5 days vs. 4.2 days, P<0.001) for any infection overall and 7 of 13 other infections. Adjusting for age, race, sex, and insurance coverage, PN was associated with higher cost (+30%, 95% CI: +17% - +44%) and higher length of stay (+30%, 95% CI: +18% - +44%) for any infection overall, as well as several other infections. These associations remained with alternate regression models adjusting for severity of illness.There is a high infectious disease burden among PN patients, corresponding to higher healthcare utilization and spending. Clinicians must be aware of these associations when treating PN patients with immunomodulatory drugs.

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Authors: N Sutaria, J Choi, Y S Roh, M P Alphonse, W Adawi, J Lai, J R Pollock, N Fontecilla Biles, S Gabriel, R Chavda, S G Kwatra