Femoral neck fractures (FNF) in older adults are frequently managed with either total hip arthroplasty (THA) or hemiarthroplasty (HA). Despite improvements in surgical techniques, mortality rates after hip fracture surgery remain high. Identifying predictors of early mortality may enhance surgical decision-making, optimize perioperative management, and improve patient outcomes. The purpose of this study was to determine the short- and mid-term mortality rates after THA and HA for FNF, to identify clinical, demographic, and laboratory factors associated with 30-, 90-, and 180-day mortality, and to establish clinically relevant cutoff thresholds for significant continuous variables to stratify risk. We retrospectively reviewed 2379 consecutive patients treated for sub-capital FNF at a tertiary trauma center between [insert study years]. Of these, 831 underwent THA and 1548 underwent HA. Mortality was assessed at 30, 90, and 180 days postoperatively. Demographic, clinical, and laboratory parameters were analyzed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curve analysis was performed to identify optimal cutoff thresholds for significant continuous predictors. Among THA patients, mortality was 1.4% at 30 days, 3.4% at 90 days, and 5.1% at 180 days. Postoperative albumin ≤2.85g/dL predicted 30-day mortality, while C-reactive protein (CRP)>19.15mg/dL was independently associated with mortality at 90 and 180 days. Among HA patients, mortality was 6.6% at 30 days, 12.9% at 90 days, and 17.6% at 180 days. Predictors of 30-day mortality included white blood cell count (WBC)>14.48×109/L, albumin <3.55g/dL, and Charlson Comorbidity Index (CCI)>7.5. At 90 and 180 days, age >83.65 and>89.34 years, WBC >13.49×109/L, albumin <3.35-3.45g/dL, creatinine >1.08mg/dL, and CCI >6.5 were associated with higher mortality risk. This study identified several laboratory and clinical markers that predict short- and mid-term mortality following hip arthroplasty for FNF. Hypoalbuminemia, elevated inflammatory markers, renal dysfunction, and high comorbidity burden were consistent risk factors. Incorporating these parameters into preoperative assessment may improve patient selection, perioperative optimization, and shared decision-making. III.

Geriatric syndromes, comorbidities, and polypharmacy: Determinants of health-related quality of life in hospitalized older adults in South India.

Owing to the global aging of people with multiple sclerosis (pwMS), there is an emerging need to distinguish neurological disability from age-related conditions in this population. To examine the overlap between frailty, disability, and comorbidity in pwMS, and their associations with quality of life (QoL) and falls. Two hundred and three pwMS (mean age=51.8 ± 12.6 years; median Patient Determined Disease Steps (PDDS) score=1.0 [IQR=2.0]; 73.9% women) underwent established assessments of frailty (FRAIL scale, Tilburg frailty indicator, and frailty index), disability (PDDS), comorbidity (Charlson comorbidity index), QoL (MSQoL-54), and falls (12-month fall-history survey). Frailty, disability, and comorbidity were distinct but overlapping: 1.5-10.3% of participants had frailty alone, 4.4-14.3% had disability alone, and 11.8-14.3% had comorbidity alone; between 9.4% and 19.7% had all three. Multivariable quantile and logistic regression analyses revealed that all frailty measures were more strongly associated with lower QoL (median regression coefficients ≤-4.76, p-values˂0.001) and greater odds of falling (ORs ≥1.47, p-values≤0.001) than disability or comorbidity. Participants with all three conditions had significantly worse physical QoL and a higher median number of falls than those with any one condition alone. Frailty, disability, and comorbidity represent separate conditions in pwMS, as they can present in isolation, and each has distinct associations with QoL and falls. Comprehensive assessment of all three conditions may enhance risk stratification and inform individualized rehabilitation and aging support strategies.

Mortality is high both during intensive care unit (ICU) stay and in the year following discharge, yet factors influencing long-term survival remain poorly defined. We hypothesized that pre-existing chronic conditions may be more strongly associated with post-ICU survival than acute illness severity or admission diagnosis. This is a post-hoc analysis of the prospective, observational, multicenter FROG-ICU cohort, which included all consecutive patients admitted to 21 French ICUs and followed for one year after discharge. ICU survivors with complete data on admission severity scores (Sequential Organ Failure Assessment [SOFA], Simplified Acute Physiology Score II [SAPS-II]), comorbidities (Charlson Comorbidity Index [CCI]), and cardiovascular/renal biomarkers at discharge (n=1400) were included. Associations with one-year mortality were assessed using Cox models. Discriminatory performance was evaluated with time-dependent area under the receiver operating characteristic curve (AUC). Among 1548 ICU survivors, 1400 were analyzed (median age 61years, 63% male). Admission diagnoses included acute respiratory failure (19%), septic shock (24%), and neurologic conditions (16%). The CCI was the strongest predictor of mortality at day 7 (AUC 0.70 [95% Confidence Interval [CI], 0.64-0.77]), at 3weeks (AUC 0.75 [0.69-0.78]), and remained high over one year, outperforming SAPS-II (0.63 [0.54-0.72]) and SOFA (0.61 [0.53-0.68]). Although cardiovascular (NT-proBNP, bio-ADM) and kidney (pNGAL) biomarkers had comparable short-term discriminatory value, CCI performed better for long-term outcomes across different admission diagnoses. In this analysis, pre-existing chronic conditions were primary drivers of short- and long-term survival after ICU discharge, exceeding prognostic value of acute illness severity at admission. French and European Outcome Registry in Intensive Care Units (FROG-ICU) study: ClinicalTrials.govNCT01367093. Registered 3 June 2011.

Questioning adjuvant therapy and surveillance in octogenarians after right hemicolectomy.

Long-term use of Benzodiazepines and Z-drugs: A register-based cohort study in Taiwan.

Central Nervous System Medication Use Among Older Adults in Korean Long-Term Care Facilities: A Multilevel Analysis.

Sepsis causes significant mortality in patients. Typically, the Sequential Organ Failure Assessment (SOFA) score is used; however, recent studies have demonstrated improved predictive accuracy by using inflammatory biomarkers such as serum ferritin and the neutrophil-to-lymphocyte ratio (NLR). Serum ferritin, although traditionally associated with iron metabolism, also acts as an acute-phase reactant reflecting systemic inflammation. To assess the prognostic value of integrating ferritin and NLR with SOFA in predicting mortality in critically ill patients with sepsis. Medical Information Mart for Intensive Care database-IV database was used to conduct this retrospective cohort study. Patients were divided into quartiles based on values of serum ferritin and NLR. Cox proportional hazards regression assessed the association with 30-day mortality, adjusted for age, sex, and the Charlson comorbidity index. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC), calibration plot, and net reclassification index (NRI). Bootstrapped internal validation was performed using 1000 resamples. Patients in the ferritin Q1 quartile (lowest ferritin quartile) had 30% lower adjusted mortality risk (hazard ratio [HR]: 0.71, 95% confidence interval [CI]: 0.57-0.9; P = 0.005) compared to Q3 (highest ferritin quartile). Similarly, NLR Q1 (lowest NLR quartile) had 27% lower adjusted mortality risk (HR: 0.73, 95%CI: 0.59-0.91; P = 0.006). Moreover, patients with both serum ferritin and NLR in the Q1 (lowest) quartile had the lowest risk of mortality (HR: 0.56, 95%CI: 0.42-0.74; P < 0.001). With biomarker integration, the AUROC improved from 0.602 (95%CI: 0.574-0.630) for SOFA alone to 0.656 (0.629-0.683; P < 0.001), primarily driven by ferritin. NRI demonstrated a modest but significant improvement in reclassification. Old age was also found to be associated with a higher risk of mortality. Lower ferritin and NLR are associated with reduced 30-day mortality, with ferritin markedly improving SOFA-based prediction and NLR offering minimal added benefit. Accessible biomarkers enhance early risk assessment in low-resource intensive care units.

Sterotactic ablative radiotherapy vs. thermal ablation of localized renal cell carcinoma: Is there a preferred second-line management option?

Background Rural-urban disparities in health care are prevalent in the United States. Our aim was to identify patterns in patient characteristics and outcomes of emergency department (ED) visits for five cardiovascular disease (CVD) diagnoses: myocardial infarction, heart failure, hypertension, atrial fibrillation, and stroke. Methods ED visits were identified in the 2016–2020 Nebraska (NE)-State Emergency Department Database and NE-State Inpatient Database. ED visits were stratified by patient urbanicity defined by Rural Urban Continuum Codes (Urban: 1–3, Micropolitan: 4–7, Rural: 8–9). Outcomes (inpatient mortality, length of stay, cost, 30- and 90-day ED revisits) were assessed via multivariable logistic regression and lognormal models adjusting for type of CVD, comorbidity burden via Charlson Comorbidity Index, age, sex, insurance, and income. Results There were 47,369 ED visits for CVD. Urban patients were younger, had more private insurance, and were more commonly in the highest income quartile. Transfers were more common for rural and micropolitan patients. For patients admitted to the presenting hospital, micropolitan and rural patients had 60 and 97% greater adjusted odds of inpatient mortality compared to urban patients. Similarly, micropolitan patients had 10% increased cost, and rural patients had 13% increased cost. Micropolitan patients had 18 and 15% lower odds of a 30- and 90-day revisit, whereas rural patients had 25 and 40% lower odds of a 30- and 90-day revisit compared to urban patients. Conclusion ED visits for CVD had significant urban-rural variation in patient characteristics, cost, revisit rate, and mortality. A disparity in cardiovascular outcomes exists in more rural areas of NE. These findings warrant further investigation and may inform population health initiatives.

Until the early 2020s, standard mantle cell lymphoma (MCL) treatment in Germany primarily included chemoimmunotherapy, autologous stem cell transplantation (autoSCT) for eligible patients in first line, and covalent Bruton tyrosine kinase inhibitors (cBTKis; ibrutinib at the time) for relapsed/refractory disease. However, real-world data on MCL treatment patterns and outcomes in Germany remain scarce. This retrospective observational study analyzed administrative claims data between 2015 and 2020. Annual incidence and prevalence, treatment patterns, healthcare visits, and overall survival (OS) were evaluated. Extrapolated to the German statutory health insurance population, annual MCL prevalence and incidence rates (per 100,000 individuals) ranged from 6.64 to 10.02 and from 1.28 to 2.06, respectively, showing an upward trend. Among 369 patients with MCL in the database (2015-2020) receiving at least one anti-cancer treatment, median age at diagnosis was 71 years and average Charlson Comorbidity Index was 2.9. In first-line, patients mainly received chemoimmunotherapy (77.2%; n = 285); 13.8% (n = 51) underwent autoSCT, and 30.9% (n = 114) received rituximab maintenance; in second-line (n = 193), 45.6% received chemoimmunotherapy and 22.3% a cBTKi. Median OS from diagnosis was 6.3 years. In cBTKi-treated patients (n = 82), median OS from first cBTKi therapy initiation (> 75% of the patients received cBTKi in second or third line) was 11.2 months, decreasing to 3.0 months from cBTKi discontinuation (n = 45). This study presents the first comprehensive analysis of MCL epidemiology, treatment patterns, and survival outcomes in Germany using claims data. Findings indicate rising MCL incidence and prevalence, a high treatment burden and poor survival outcomes, underscoring the need for treatment advancements.

This study aimed to systematically assess the incidence of acute respiratory distress syndrome (ARDS) among Chinese patients with severe acute pancreatitis (SAP) and to identify factors independently associated with ARDS in multivariable models, with a view to providing a scientific basis for the early prevention and management of ARDS in this population. A comprehensive search of nine Chinese and English databases was conducted to identify studies reporting the incidence or factors associated with ARDS in SAP patients. Studies were selected based on stringent inclusion and exclusion criteria. Relevant data were extracted, and study quality was assessed. A meta-analysis was performed using R 4.4.2 and Stata 16.0 software. Seventeen studies involving 3,576 SAP patients were included. The pooled incidence of ARDS was 36.38% (95% CI: 30.66%-42.50%). However, substantial between-study heterogeneity was observed (I² = 92.4%), and the prediction interval was wide (15.73%-63.66%), indicating that this pooled estimate should be regarded as a statistical average across different clinical settings rather than a stable nationwide epidemiological parameter. Seventeen factors were identified as independently associated with ARDS in multivariable analyses, including two demographic variables (age > 50 years and female sex), three clinical scoring systems (Charlson Comorbidity Index ≥ 3, Acute Physiology and Chronic Health Evaluation II score > 11, Ranson score > 5), four comorbidities (sepsis, abdominal compartment syndrome, ≥ 2 extrapulmonary organ failures, and concurrent infections), and eight physiological and biochemical markers (albumin ≤ 30g/L, triglycerides > 1.7 mmol/L, fasting blood glucose > 12 mmol/L, C-reactive protein > 150mg/L, neutrophil count > 14 × 10⁹/L, procalcitonin > 0.5 ng/mL, platelet count < 125 × 10⁹/L, lactate dehydrogenase > 250 U/L). It should be noted that the evidence for nine of these factors was derived from a single study each, and the generalizability of these variables as independent correlates requires further validation. All included studies were of moderate to high quality but generally demonstrated poor control for confounding factors. The reported incidence of ARDS among Chinese patients with SAP is high and is independently associated with multiple demographic characteristics, clinical scores, comorbidities, and physiological or biochemical markers. Recognition of these factors, which demonstrated independent associations in multivariable models, may inform ARDS risk assessment in patients with SAP; however, their clinical utility should be interpreted with caution in light of limitations in study design.

Imatinib has revolutionized the management of chronic-phase chronic myeloid leukaemia (CP-CML). This study aimed to evaluate the long-term efficacy, safety and prognostic determinants of imatinib in a large cohort of CP-CML patients in real-life clinical practice. We conducted a retrospective, monocentric observational study including all adult patients with CP-CML treated with imatinib between 2000 and 2025. Overall survival (OS), event-free survival (EFS) and progression-free survival (PFS) were estimated using Kaplan-Meier analysis. A total of 210 patients were included, of whom 81% received imatinib as first-line therapy. The median follow-up was 12.4 years. At 25 years, OS and PFS were 71% and 88% respectively. The EUTOS long-term survival (ELTS) score independently predicted OS, EFS and PFS (p < 0.001), while lower risk categories were associated with a faster achievement of major molecular response (MMR) and a higher probability of deep molecular response (DMR). Dose reductions were applied in 26.2% of patients, mainly older individuals with higher Charlson comorbidity index (CCI), without affecting molecular or survival outcomes. Higher CCI values correlated with inferior OS. The ELTS score remains a powerful prognostic tool for long-term outcomes. No unexpected safety concerns were observed in the long term. Over 25 years of real-world experience, imatinib has demonstrated sustained efficacy, safety and tolerability in CP-CML.

The impact of conversion arthroplasty for failed femoral neck or intertrochanteric fractures on complication and mortality rates: A "second-hit" effect?

To investigate the association between skeletal muscle mass loss and long-term outcomes in patients with intraductal papillary mucinous neoplasm (IPMN). This retrospective, single-center cohort study included 700 patients diagnosed with IPMN at Hokkaido University Hospital between April 2011 and April 2023. Skeletal muscle mass was assessed using the psoas muscle index (PMI) measured on a computed tomography scan at the initial visit. The primary outcome was the incidence of pancreatic cancer, and the secondary outcome was overall mortality. Cox proportional hazard models and competing risk analyses were employed to identify independent risk factors. During a median follow-up of 71 months, 27 patients developed pancreatic cancer with an annual incidence rate of 0.63% (95% CI: 0.55-1.86%). Patients with a low PMI had a significantly higher risk of pancreatic cancer than those with a high PMI (adjusted HR: 3.44, 95% CI: 1.62-7.32, P <0.01). Multivariate analysis identified a low PMI and a main pancreatic duct diameter ≥5mm as independent risk factors for the development of pancreatic cancer. Among the 69 deaths, 61 were comorbidity-related and 8 were pancreatic cancer-related. Low PMI (adjusted HR: 2.57, 95% CI: 1.60-4.12, P <0.01) and a high age-adjusted Charlson Comorbidity Index (aCCI) (adjusted HR: 9.06, 95% CI: 4.63-17.72, P <0.01) were independently associated with all-cause mortality. Competing risk analysis revealed that skeletal muscle mass loss was significantly associated with the incidence of pancreatic cancer in patients with a low aCCI score but not in those with a high aCCI score. Skeletal muscle mass loss was an independent risk factor for all-cause mortality, and it might be associated with the risk factor for the incidence of pancreatic cancer, particularly IPMN-derived carcinoma in patients with IPMN. Patients with a low PMI and minimal comorbidities might be better to undergo long-term surveillance due to their increased risk of pancreatic cancer.

Introduction: Introduction: The use of portable ventilators (PV) adapted to tracheostomy has been observed in critical patients in clinical practice. Objective: The study aimed to identify the characteristics associated with the indication for PV, patient outcomes, and survival. Methods: This was a prospective cohort study conducted with adult tracheostomized patients. Data collected included demographics, severity scores, reasons for ICU admission and intubation, days of mechanical ventilation (MV) until tracheostomy, cause of tracheostomy, and outcomes (ICU and hospital). Univariate analysis compared the groups with and without PV. Odds ratios (OR) assessed the likelihood of PV use, and age-adjusted logistic regression evaluated associated variables. Hospital survival was studied using the Kaplan-Meier method. Results: A total of 95 patients were included. The mean age was 71 years, with 58% being female. The median SAPS II was 55, and the Charlson Comorbidity Index was 4. Patients with an indication for PV (n=71) were older and had a longer continuous sedation time. Those intubated due to acute respiratory failure had a lower chance of using PV than those intubated for other causes. Hospital survival was higher in the PV group; however, the hospital mortality rate did not differ between the groups. Conclusion: PV use in tracheostomized patients was greater in the elderly and those intubated due to neurological causes or COPD. Despite higher survival, the similar hospital mortality rate suggests the need for further interventions. The literature reinforces that a multidisciplinary approach is essential to manage the complex dysfunctions in these patients with prolonged hospitalization.

BackgroundThe community 5-year management rate, defined as the proportion of patients with dementia who remain in community-based informal care without long-term institutionalization 5 years after diagnosis reflects the effectiveness of national dementia strategies and social care systems.ObjectiveTo examine national trends in the 5-year community management rate of dementia and assess whether disparities in dementia care outcomes have changed by demographic, socioeconomic, and clinical characteristics.MethodsThis retrospective, population-based cohort study used a customized research database from the Korean National Health Insurance Service (2003–2021). Subgroup analyses were performed by age, sex, income, region (metropolitan vs. non-metropolitan), Charlson Comorbidity Index, diagnosing department (neurology/psychiatry vs other). The study population included patients newly diagnosed with dementia per annum during the study period. The primary outcome was the proportion of patients remaining in community 5 five years after diagnosis, without long-term institutionalization. Secondary outcomes included disparities in management rates across subgroups.ResultsOverall 779,558 patients were included. The 5-year community management rate showed continued improvement over time. Disparities by sex, residence, and income narrowed steadily between 2003 and 2016. Patients diagnosed in neurology or psychiatry consistently had higher management rates than those diagnosed in other departments, and this gap widened over time.ConclusionsCommunity management rates are influenced by social and personal factors. While disparities by sex, income, and residence decreased, persistent differences by comorbidity and diagnosing department highlight the need for targeted policy interventions. The 5-year community management rate may serve as a meaningful indicator of real-world dementia care outcomes.

Peripheral artery disease (PAD) is the third leading cause of atherosclerotic morbidity. The influence of comorbidity burden on the prognosis of PAD patients is still underestimated. The Charlson Comorbidity Index (CCI) is an established tool for evaluating patients' comorbidity burden. We used the German nationwide inpatient statistics including all hospitalizations of patients admitted due to PAD in Germany 2005-2022 and categorized according CCI classes (mild: CCI=1-2points, moderate: CCI=3-4points, high severity: CCI>4points). Overall, 3,167,987 hospitalizations of PAD patients were included in our study. Of these, 10.3% were categorized as mild, 34.3% as moderate and 55.4% as high-severity CCI class. Comorbidity burden and particularly frequency of high-severity CCI class increased from 51.2% (2006) to 58.5% (2022).An increase in the CCI class was associated with increased likelihood of being treated endovascularly (OR 1.48, 95%CI 1.48-1.49, P<0.001) rather than surgically (OR 0.87, 95%CI 0.87-0.88, P<0.001). An increase in the CCI class was associated with an elevated risk for major adverse cardiovascular and cerebrovascular events (MACCE) (OR 9.66, 95%CI 9.45-9.88, P<0.001), amputation (OR 2.82, 95%CI 2.80-2.84, P<0.001) and in-hospital case-fatality (OR 9.87, 95%CI 9.62-10.12, P<0.001). PAD patients' comorbidity burden increased during the observational period between 2005 and 2022 in Germany. Higher comorbidity burden mirrored by higher CCI class was associated with an approximately 10-fold increased risk for MACCE and in-hospital mortality. Physicians have to be aware for the impact of comorbidity burden and optimization of the comorbidities is an important focus to improve outcomes and prevent complications.

Although etiology is considered central to outcomes in status epilepticus (SE), previous studies often lacked standardized classification and adjustment for confounders, particularly withdrawal of life-sustaining treatment (WLST). This study examined the association between SE etiology, mortality, and neurologic recovery using the International League Against Epilepsy (ILAE) classification while accounting for confounders and WLST. This 2-center observational study included adults (≥18 years) with SE treated at the University Hospitals of Basel and Geneva from 2015 to 2023. Etiologies were classified as acute symptomatic, remote symptomatic-unprovoked, progressive CNS disorders, epilepsy without additional triggers, or cryptogenic. Demographics, SE type, SE severity score, Charlson Comorbidity Index, treatment data, complications, and WLST were assessed. The primary outcome was in-hospital mortality; secondary outcomes were 30-day mortality and recovery to premorbid neurologic function at discharge. Associations were assessed using Poisson regression with robust error variance, adjusted for age, nonconvulsive SE (NCSE) with coma, comorbidity, and center. Among 967 patients (median age 67 years, interquartile range 54-78; 46.5% female), SE was terminated in 95%, with 48.5% of patients recovering to premorbid function. Acute symptomatic SE accounted for 34.2%, remote symptomatic SE for 27.6%, SE due to progressive CNS disorders for 14.4%, epilepsy without additional triggers for 16.7%, and cryptogenic SE for 7.1%. In-hospital and 30-day mortality were 7.9% and 13.9%, respectively, while 48.5% recovered to premorbid function. Etiology was associated with neurologic recovery, with intracranial hemorrhage (relative risk [RR] 0.49, 95% CI 0.35-0.67) and acute symptomatic SE (RR 0.71, 95% CI 0.60-0.83) being associated with reduced likelihood of recovery, whereas known epilepsy was associated with increased likelihood of recovery (RR 1.40, 95% CI 1.23-1.60). NCSE with coma (11.9%) was independently associated with higher in-hospital and 30-day mortality and reduced recovery across all ILAE etiology groups. WLST did not significantly alter these associations. Etiology was associated with neurologic recovery but not with short-term mortality after adjustment for confounders and WLST. By contrast, NCSE with coma showed the strongest association with adverse outcomes. This suggests that while etiology informs prognosis for recovery, SE type, particularly NCSE with coma, is the more critical determinant of survival.

Generalized pustular psoriasis (GPP) is rare, chronic, and associated with life-threatening complications. We investigated the burden of GPP in France. Using data from 2010 to 2021 in the Système National des Données de Santé database, healthcare resource utilization (HCRU), costs, comorbidities, mortality, and treatments were compared among GPP (N = 4351), plaque psoriasis (N = 12,945), and general population (N = 12,981) cohorts, matched for sex, age, Charlson Comorbidity Index (CCI) score, and region. GPP prevalence and incidence were also investigated. Annually, there were 0.5-0.8 new GPP cases per 100,000 people. Across the cohorts, 54.5-54.7% of people were male, with mean age 58.7-59.5years and mean CCI score 1.98-2.06. The GPP cohort incurred significantly greater HCRU and costs versus the plaque psoriasis and general population cohorts, including greater proportions of patients receiving emergency care (78% vs 63% and 55%) and intensive care (28% vs 17% and 14%), longer hospitalizations (mean 38.5 vs 26.2 and 22.4days per patient), and higher medication costs (€4360 vs €1991 and €1543 per patient-year), respectively. Despite similar CCI scores, GPP was associated with more cardiometabolic and psychological comorbidities versus the plaque psoriasis and general population cohorts, e.g., hypertension (37% vs 21% and 20%), obesity (21% vs 9% and 6%), depression (13% vs 4% and 4%), alcohol abuse (16% vs 3% and 3%), and sleep disorders (8% vs 4% and 3%), respectively. Treatments in the GPP cohort were those used for plaque psoriasis, including topical steroids (77%), systemic steroids (50%), and biologics (23%). Twelve-month survival was 86.9% (GPP), 97.5% (plaque psoriasis), and 90.0% (the general population). HCRU, costs, and comorbidities with GPP were often double those for comparator cohorts, and mortality was higher. These findings highlight the need to use GPP-targeted treatments that improve patient outcomes and may reduce the burden on healthcare systems.