Adult patients with acute generalized exanthematous pustulosis (AGEP) are more likely to have longer hospital stays and to be discharged to long-term care facilities, according to findings from a cross-sectional analysis published in the American Journal of Clinical Dermatology.
Investigators identified patients with potential AGEP from an inpatient database based on their diagnoses codes while in the hospital and at discharge, as well as detailed chart reviews and noting if patients met clinical criteria for AGEP. The primary outcomes included length of hospital stay, discharge disposition, 1-year readmission, and hospitalization and 30-day mortality. They compared hospitalization outcomes between groups using Chi-square analysis for categorical variables and Student’s t test for continuous variables. They used a multivariable logistic regression model to assess the association between AGEP diagnosis and demographic variables.
There were 65 adult patients with AGEP and 61 control patients with nonsevere cutaneous drug reactions included in the study. Patients with AGEP had a mean age of 60.3 years, 58% were women, and control patients had a mean age of 53.3 years and 46% were women; researchers noted that both mean ages were statistically significant (P =.010). Body mass index was significantly higher in the AGEP cohort. Charlson comorbidity scores, insurance type, and poverty quintiles were similar between groups. The most commonly identified cause of AGEP was antibiotic usage.
Mean length of hospital stay was longer in the AGEP group compared to control patients (P <.001). In terms of discharge disposition, more patients with AGEP were discharged to long-term care facilities than control patients (P <.001). Inpatient mortality was higher in the overall AGEP cohort compared with control patients (P <.049), but not in the sub-cohort with a primary discharge diagnosis of AGEP. Chart reviews revealed that hospital deaths were caused by diagnoses other than AGEP. Readmission rates within 1 year and 30-day mortality rates were similar between groups.
The study was limited by its retrospective, single-center design.
“Future research should examine opportunities to decrease hospitalization length given the low risk of mortality among patients with AGEP, and further examine the association of morbid obesity and this particular drug reaction,” the study authors wrote.
Nusbaum KB, Walker TD, Himed S, et al. Patient care outcomes in hospitalized patients with acute generalized exanthematous pustulosis: a cross-sectional database study. Am J Clin Dermatol. Published online October 28, 2022. doi:10.1007/s40257-022-00737-5