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）成人患者常合并多种基础疾病，且其接受的治疗方案可能会提升严重感染的发生风险。
研究目的：估算化脓性汗腺炎成人患者非皮肤感染（non-cutaneous infections, NCI）相关住院的患病率及其危险因素，并分析其医疗服务利用模式。
研究方法：本回顾性队列研究纳入2018年至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。通过主要及次要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及急诊室（emergency department, ED）就诊数据，以评估整体医疗服务利用情况。
研究结果：本研究共纳入834名化脓性汗腺炎患者，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（urinary tract infections，占比18.8%）、肌肉骨骼感染（占比13%）及新型冠状病毒感染（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保（比值比（odds ratio, OR）=2.05；置信区间（confidence interval, CI）：1.08~3.76）、慢性肾脏病（OR=6.42；CI：1.68~24.21）及焦虑症（OR=3.13；CI：1.63~5.93）。非精神科住院患病率为24.6%，急诊室就诊率为45.3%。
研究局限性：本研究仅纳入单一医疗系统的患者，研究结果的外推性存在局限。
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，其中以尿路感染最为常见。合并焦虑症或慢性肾脏病的患者感染风险更高。未来的研究应聚焦于感染预防的干预措施与手段。