Patients with atopic dermatitis (AD) experienced lower 30-day readmission rates but higher comorbidity burden from 2010 to 2018, according to findings from a longitudinal analysis published in the Journal of The European Academy of Dermatology and Venereology.

Investigators obtained data on 30-day readmission rates of patients with atopic dermatitis in the US using national population data and performed a retrospective 9-year longitudinal trend analysis from 2010 to2018. They included index hospitalizations for all adult AD patients with any diagnosis of AD using ICD 9 and 10 codes for the corresponding year, and excluded elective and traumatic readmissions. Secondary outcomes included trends in readmission length of hospital stay (LOS), total hospital cost (THC), and Charlson comorbidity index score (CCI). Investigators adjusted for change in demographics and CCI over time.

There were 22,069 index hospitalizations included in the analysis. There was a decrease in 30-day readmission rates, from 13.5% in 2010 to 10.8% in 2018 (adjusted P-trend =.0001). There was an increase in the percentage of patients with a CCI score of 3 or greater, from 29.2% in 2010 to 38.4% in 2018, while those with a CCI score of 0-2 decreased from 70.8% in 2010 to 61.6% in 2018 (adjusted P-trend =.037). Common reasons for readmission were sepsis, cellulitis, chronic obstructive pulmonary disease, asthma, and psychiatric illness.


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Mean LOS of readmissions reduced nonsignificantly from 6.2 days in 2010 to 5.9 days in 2018, and THC increased nonsignificantly from $10,773 in 2010 to $13,270 in 2018.

The study was limited by using the Nationwide Readmission Database (NRD) which is based on ICD coding and may contain coding errors, and does not contain information on race, medication compliance, or pediatric patients. Investigators were also unable to analyze predictors of readmission.

Given the increase in ICC over time, the study authors recommended “a multidisciplinary approach” to identify and manage comorbidities in AD patients as a way preventing unplanned 30-day readmissions.

Reference

Edigin E, El-Amir Z, Wani F, Kichloo A, Eseaton PO. Trends of readmissions of atopic dermatitis patients in the United States: a 9-year longitudinal analysis of the Nationwide Readmission Database. J Eur Acad Dermatol Venereol. Published online July 26, 2021. doi:10.1111/jdv.17556