The Inpatient Burden of Autoimmune Blistering Disease in US Children: Analysis of Nationwide Inpatient Sample Data
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Little is known about the epidemiology of pediatric autoimmune blistering disorders (PAIBD).
We sought to determine the inpatient burden and comorbidities of PAIBD.
We analyzed data from the Nationwide Inpatient Sample from 2002 to 2012, which contained a representative 20% sample of all US hospitalizations.
The most common PAIBD with a primary admission was pemphigus (8.0 per million), whereas the most common secondary diagnosis of PAIBD was dermatitis herpetiformis (DH; 9.6 per million). Bullous pemphigoid (BP) was inversely associated with being female and having government or no insurance but positively associated with Black and Hispanic race/ethnicity and more chronic conditions. Pemphigus was associated with being female, Hispanic, having government or no insurance, and having a higher number of chronic conditions. DH was inversely associated with non-White race but positively associated with having government insurance and more chronic conditions. BP was associated with dialysis, hypertension, and diabetes. Pemphigus was associated with osteoarthritis, renal failure, hypothyroidism, and weight loss. DH was associated with herpes simplex virus infection, rheumatoid arthritis, and fungal, viral, and other skin infections.
PAIBD are associated with a considerable inpatient burden and comorbid health conditions.
Study concept and design: JI Silverberg. Acquisition of data and statistical analysis: JI Silverberg, D Hsu, Z Ren. Analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content: Z Ren, JI Silverberg, D Hsu, NB Silverberg. Obtained funding: JI Silverberg. No administrative technical or material support was received. Study supervision: None. Financial disclosures: None. JI Silverberg had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis.
Compliance with Ethical Standards
This publication was made possible with support from the AHRQ, Grant Number K12HS023011, the Dermatology Foundation, and the American Medical Association Foundation. The funder was not involved in the design and conduct of the study; the collection, management, analysis, and interpretation of data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
Conflict of interest
Ziyou Ren, Derek Y. Hsu, Nanette B. Silverberg, and Jonathan I. Silverberg have no conflicts of interest that are directly relevant to the content of this article.
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