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Increased healthcare burden and comorbidity risks of pediatric patients with dystrophic epidermolysis bullosa: Analysis of Nationwide Emergency Department Sample 2015-2019.
Molnar, Brenda Abreu; Yang, Lynna J; Paller, Amy S; Ren, Ziyou.
Afiliación
  • Molnar BA; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Yang LJ; Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.
  • Paller AS; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Ren Z; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Pediatr Dermatol ; 41(5): 800-806, 2024.
Article en En | MEDLINE | ID: mdl-39049693
ABSTRACT

BACKGROUND:

Dystrophic epidermolysis bullosa (DEB) describes a rare genetic blistering disorder characterized by fragile skin. This study aimed to classify the frequency, demographics, cost, and comorbidities associated with emergency department (ED) visits due to DEB.

METHODS:

The Nationwide Emergency Department Sample (NEDS) was analyzed for pediatric (age <18) ED visits from 2015 to 2019. DEB was identified with ICD-10-CM code Q81.2. Weighted frequency, prevalence, and 95% confidence intervals (CIs) of comorbidities were determined among ED visits with and without a DEB diagnosis.

RESULTS:

From 2015 to 2019, 53 (weighted 242) cases of DEB among 27,223,220 pediatric ED visits were captured. Patients with DEB were more likely to visit the ED in summer compared with those without a diagnosis of DEB (35.7% vs. 21.4%, P < .05). More than half of patients with DEB were admitted to the hospital (56.2%, 95% CI 39.3-72.5, P < .001) versus only 3.4% (95% CI 3.1-3.7) of other patients. For ED visits with a secondary DEB diagnosis, the top three primary diagnoses were fever, constipation, and bone marrow transplant aftercare. Patients with DEB had higher rates of hypertension, cellulitis, sepsis, acute and chronic kidney injury, esophageal obstruction, gastroesophageal reflux disease, cardiomyopathy, and anxiety, compared to patients without DEB (all P < .001).

CONCLUSIONS:

DEB is a complex blistering disorder with multisystemic manifestations. Patients with DEB have significantly higher admission rates and commonly present with infectious or gastrointestinal complications. Understanding the features of ED visits due to DEB can better prepare healthcare teams and improve patient outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Comorbilidad / Epidermólisis Ampollosa Distrófica / Servicio de Urgencia en Hospital Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: America do norte Idioma: En Revista: Pediatr Dermatol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Comorbilidad / Epidermólisis Ampollosa Distrófica / Servicio de Urgencia en Hospital Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: America do norte Idioma: En Revista: Pediatr Dermatol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos