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Characteristics of hospitalized dermatomyositis patients with underlying malignancy: a nationally representative retrospective cohort study

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Abstract

Introduction

Little is known regarding characteristics of hospitalized dermatomyositis (DM) patients. Understanding the unique characteristics of hospitalized DM patients with underlying malignancy is important in guiding development of specific work-up and treatment algorithms.

Objectives

We aim to characterize the inpatient burden of DM patients with malignancy (DM malignancy), determine unique characteristics of DM-malignancy inpatients, and assess trends and predictors of cost of care and length of stay for hospitalized DM-malignancy patients.

Methods

Hospitalized DM patients with and without malignancy were characterized and compared using 2009–2015 National Inpatient Sample. Associated malignancies, risk factors for malignancy, and trends/predictors for cost of care and length of stay were evaluated using multivariable models.

Results

Prevalence of malignancies among hospitalized DM inpatients was 10.9%. Age > 40 years and female sex were significantly associated with increased malignancy risk in DM inpatients. Numerous malignancies were significantly more common in men with DM compared to women, including bronchial, non-Hodgkin’s lymphoma, head/neck, bladder, esophageal, kidney, and stomach. The most common malignancies in women with DM were breast and ovarian. Head/neck carcinomas were more common in hospitalized DM patients than previous cohorts evaluating outpatients. Socioeconomic characteristics differed between DM patients with/without malignancy. The presence of underlying malignancy did not affect hospitalization cost, length of stay, or mortality in the hospitalized DM population. The economic burden of hospitalized DM patients is increasing over time.

Conclusions

DM inpatients with malignancy display numerous differences compared to DM inpatients without malignancy. Further research characterizing hospitalized DM patients is warranted in order to optimize work-up and treatment guidelines for these patients.

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Acknowledgments

We would like to acknowledge the Medicine, Society, and Culture program in the Department of Bioethics at Case Western Reserve University School of Medicine for supporting our access to this database.

Funding

There is no financial support for this study.

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Authors and Affiliations

  1. Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Lakeside 3500, 11100 Euclid Avenue, Cleveland, OH, 44106, USA

    Raghav Tripathi

  2. Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA

    Anthony P. Fernandez

  3. Department of Pathology, Cleveland Clinic, Cleveland, OH, USA

    Anthony P. Fernandez

Authors
  1. Raghav Tripathi
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Contributions

RT had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: RT, APF. Acquisition, analysis, and interpretation of data: RT. Drafting of the manuscript: RT, APF. Critical revision of the manuscript for important intellectual content: RT, APF. Statistical analysis: RT. Administrative, technical, or material support: RT, APF. Study supervision: RT, APF.

Corresponding author

Correspondence to Raghav Tripathi.

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Conflicts of Interest

A.P.F. is an investigator for Pfizer, Corbus, Mallinckrodt, and Novartis pharmaceuticals. He receives personal research support from Mallinckrodt and Novartis; honorarium from AbbVie, UCB, Novartis, and Mallinckrodt for consulting and advisory board participation, and honorarium from AbbVie, Novartis and Mallinckrodt for teaching and speaking. R.T. reports no conflicts of interest.

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Tripathi, R., Fernandez, A.P. Characteristics of hospitalized dermatomyositis patients with underlying malignancy: a nationally representative retrospective cohort study. Arch Dermatol Res 313, 473–482 (2021). https://doi.org/10.1007/s00403-020-02127-5

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  • DOI: https://doi.org/10.1007/s00403-020-02127-5

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