386 Incidence, co-morbidity burden and resource utilization of psoriasis hospitalization has increased in the last decade: A 11-year longitudinal study of the national inpatient sample

Abstract

This study aims to study longitudinal trends of psoriasis hospitalizations over time in the United States (US) using national population data. Data were obtained from the National Inpatient Sample database (NIS). We performed a retrospective 11-year longitudinal trend analysis of NIS 2008-2018 databases. We searched for hospitalizations for patients aged≥ 18 years with a principal or secondary diagnosis of psoriasis using ICD codes for the corresponding year. Multivariate logistic and linear regression was used to calculate adjusted p-trend for categorical and continuous outcomes, respectively. The incidence of adult psoriasis hospitalizations in the U.S increased from 34 per 100,000 persons in 2008 to 52 per 100,000 persons in 2018. The mean age increased from 59.9 years in 2008 to 61.2 years in 2018 (adjusted p-trend=0.021). The proportion of whites decreased from 82.7% in 2008 to 81.5 % in 2018 (adjusted p-trend<0.0001), while that of Hispanic increased from 6.4% in 2008 to 7.8% in 2018 (adjusted p-trend=0.017). The proportion of patients with Charleston co-morbidity index (CCI) score of 0-2 decreased from 78.7% in 2008 to 63.9% in 2018, while those with CCI score of ≥3 increased from 21.3% in 2008 to 36.1% in 2018 (adjusted p-trend<0.0001). Mean hospital length of stay (LOS) increased from 4.9 days in 2008 to 5.0 days in 2018, with a peak of 5.2 days in 2014 & 2016 (adjusted p-trend=0.001). Mean adjusted total hospital cost (TOTcost) increased from 12,909 US dollars in 2008 to 14,739 US dollars in 2018 (adjusted p-trend=0.017). Incidence, age, co-morbidity burden, and resource utilization in terms of LOS and TOTcost of psoriasis hospitalizations have increased in the last decade. The racial profile has changed, with a decreased proportion of Caucasians and increased Hispanic hospitalization. Interdisciplinary collaboration is needed to optimize outcomes of hospitalized psoriasis patients with increased co-morbidity burden.