A retrospective cohort study of 834 adults with hidradenitis suppurativa found that 6.35 percent were hospitalized for serious infections unrelated to the skin during a 5-year period.
The most common noncutaneous infections (NCIs) identified were urinary tract infections (18.2 percent), musculoskeletal infections (13.0 percent), and COVID-19 infections (11.7 percent). The researchers found that patients with chronic kidney disease, anxiety, or public insurance were at the highest risk for these hospitalizations.
In the study, investigators reviewed records from a single academic health system between 2018 and 2022. All patients had a dermatologist-confirmed diagnosis of hidradenitis suppurativa (HS) with at least two related clinical visits. Patients with cancer (except nonmelanoma skin cancer), organ transplants, or human immunodeficiency virus were excluded. Most patients in the cohort were young, female, and White, with an average follow-up time of 34 months (± 17.6).
In total, 53 patients experienced 77 hospitalizations for NCIs, accounting for 18.5 percent of all nonpsychiatric hospitalizations in the cohort.
Beyond the top three infections, other common NCI-related conditions included sepsis/bacteremia (10.4 percent), liver and biliary tract infections (10.4 percent), upper respiratory infections (10.4 percent), chorioamnionitis (10.4 percent), and gastrointestinal infections such as diverticulitis or appendicitis (10.4 percent).
Multivariable logistic regression identified several independent risk factors for NCI-related hospitalization. Chronic kidney disease was the strongest predictor (odds ratio [OR] = 7.73, 95 percent confidence interval [CI] = 2.03–29.09), followed by anxiety (OR = 3.27, 95 percent CI = 1.58–6.67) and public insurance (OR = 2.06, 95 percent CI = 1.09–3.83).
Healthcare utilization in the HS cohort was high. Nearly one-quarter (24.6 percent) of patients had at least one nonpsychiatric hospital admission, and 45.3 percent had visited the emergency department (ED). Among those hospitalized, 39.5 percent were readmitted, and among those seen in the ED, 69.8 percent had recurrent visits.
Most patients (82.2 percent) had received systemic therapy for HS, including antibiotics (63.9 percent), hormone treatments (40.6 percent), or biologics (18.0 percent). Hospitalized patients were more likely to have received infliximab and antibiotics such as moxifloxacin, metronidazole, or cephalexin. Due to well-described limitations of treatment information in electronic medical records, HS therapies were collected only for population descriptions and not included in risk modeling.
Although the study was limited to a single health system and standardized measures of disease severity were not available, it provided detailed patient-level data and confirmed diagnoses. The findings underscored infection risks in patients with HS and highlighted the need for further research, especially on outpatient infections and the role of specific treatments.
The study was conducted by researchers at Brigham and Women's Hospital and Harvard Medical School. It was approved by the Mass General Brigham Institutional Review Board and followed STROBE reporting guidelines.
Source: JID Innovations
