Prevalence and Risk Factors for Hospitalization from Non-Cutaneous Infections in Patients with Hidradenitis Suppurativa _ Supplementary material

Background: Adults with Hidradenitis suppurativa (HS) have comorbidities and are subjected to treatments that may increase their risk for serious infections. Objectives: Estimate the prevalence and risk factors for non-cutaneous infections (NCI) related hospitalizations in adults with HS and analyze their patterns of healthcare utilization. Methods: This retrospective cohort included dermatologist-confirmed HS patients from a single healthcare system from 2018 to 2022. Primary/secondary diagnostic codes identified NCI-related hospitalizations. Multivariable logistic regression assessed risk factors. Non-psychiatric hospitalizations and emergency department (ED) visits were collected for overall healthcare utilization. Results: Among 834 HS patients, 6,4% were hospitalized for NCI during the study period. The most common infections were urinary tract infections (18.8%), musculoskeletal infections (13%), and Covid-19 (11.7%). The main factors associated with NCI were public insurance (OR:2.05; CI:1.08 – 3.76), chronic kidney disease (OR:6.42; CI:1.68 – 24.21), and anxiety (OR:3.13; CI:1.63-5.93). Non-psychiatric hospitalization prevalence was 24.6%, and ED visits were 45.3%. Limitations: Limited generalizability due to a single health system. Conclusions: Patients with HS have a significant prevalence of hospitalizations from NCI, with UTIs being the most prevalent. The risk was higher in those with anxiety or chronic kidney disease. Future research should focus on interventions and preventive measures to prevent infection.

研究背景：化脓性汗腺炎（Hidradenitis suppurativa, HS）成年患者常合并多种共病，且需接受可能增加严重感染风险的治疗方案。研究目的：估算化脓性汗腺炎成年患者非皮肤感染（Non-cutaneous infections, NCI）相关住院的患病率与危险因素，并分析其医疗服务利用模式。研究方法：本研究为回顾性队列研究，纳入2018至2022年间来自单一医疗系统、经皮肤科医师确诊的化脓性汗腺炎患者。通过主、次诊断编码识别非皮肤感染相关住院病例，采用多变量logistic回归分析危险因素。同时收集非精神科住院与急诊科（Emergency Department, ED）就诊数据，以评估整体医疗服务利用情况。研究结果：在834名化脓性汗腺炎患者中，研究期间有6.4%的患者因非皮肤感染住院。最常见的感染类型为尿路感染（占比18.8%）、肌肉骨骼感染（占比13%）与新型冠状病毒肺炎（Covid-19，占比11.7%）。与非皮肤感染相关的主要危险因素包括公共医疗保险（比值比OR：2.05；95%置信区间CI：1.08–3.76）、慢性肾脏病（OR：6.42；CI：1.68–24.21）以及焦虑障碍（OR：3.13；CI：1.63–5.93）。非精神科住院患病率为24.6%，急诊科就诊率为45.3%。研究局限性：本研究仅纳入单一医疗系统的患者，故研究结果的外推性存在一定局限。研究结论：化脓性汗腺炎患者因非皮肤感染住院的患病率较高，其中尿路感染最为常见。合并焦虑障碍或慢性肾脏病的患者感染风险更高。未来研究应聚焦于感染预防干预措施与相关防控手段。