The impact of underlying disease state on outcomes in patients with pyoderma gangrenosum: A national survey.

Abstract

Whether the underlying disease affects the outcomes in pyoderma gangrenosum (PG) is unclear. To determine the impact of comorbid disease associations and concomitant procedural treatments on patient outcomes in hospitalizations of patients with PG. A cross-sectional analysis of the National Inpatient Sample for hospitalizations of patients with PG from the years 2002 to 2011, analyzing in-hospital mortality rate and health care resource utilization. Inflammatory bowel disease was the most frequent comorbid association, followed by inflammatory arthritis, hematologic malignancies/dyscrasia, and vasculitis. Multivariable modeling showed that vasculitis and hematologic malignancy/dyscrasia, when compared with inflammatory bowel disease, were associated with a 4-fold to 6-fold increased risk of in-hospital mortality and increasing health care resource utilization. Inpatient procedural interventions, including skin grafts, biopsies, and debridement, did not affect mortality and were associated with an increased length of stay. The database does not account for outpatient follow-up; additionally, there was a low rate of coded comorbid conditions. Comprehensive evaluation to determine the underlying comorbidity for patients with PG is important for patient risk stratification.