Increased healthcare burden and comorbidity risks of pediatric patients with dystrophic epidermolysis bullosa: Analysis of Nationwide Emergency Department Sample 2015–2019
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 Emergenc...
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| Veröffentlicht in: | Pediatric dermatology 2024-09, Vol.41 (5), p.800-806 |
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| creator | Molnar, Brenda Abreu Yang, Lynna J. Paller, Amy S. Ren, Ziyou |
| description | 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 |
| doi_str_mv | 10.1111/pde.15688 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3084768077</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3084768077</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2788-eac1c231d62067d7b6b717a2ff5f16c9671b406771404638e265290030e9b6e13</originalsourceid><addsrcrecordid>eNp1kU9u1TAQhy1ERV8LCy6ALLGBRVpP_tgOu6p9hUpVQQLWkWNPeC5JHGxHT9lxB87RS3ESDCksKuHNSJ5vPmnmR8hzYCeQ3ulk8AQqLuUjsoEqrzIoBXtMNkwUPJOs5IfkKIRbxpjkHJ6Qw6JmZc3rYkPurkbtUQU0dIeqjzutPNJ29gZHqkZDtRucb62xcaHehq-Buo5OaKyK3mo6qWhxjIHubdxRs4To3bRLDZysQT-4fgk2JGHfu6De0LNRrT_JcpNm3bhPHN0O6L_gqBd6gZPycUhO-lENU480Z1D9_P4jlfopOehUH_DZfT0mny-3n87fZdfv316dn11nOhdSZqg06LwAw3PGhREtbwUIlXdd1QHXNRfQlqkjoEzHKSTmvMprxgqGdcsRimPyavVO3n2bMcRmsEFj36sR3RyagslScMmESOjLB-itm33aMlEAjNUAtUzU65XS3oXgsWsmbwfllwZY8zvDJmXY_MkwsS_ujXM7oPlH_g0tAacrsLc9Lv83NR8utqvyFx6_p-Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3110091198</pqid></control><display><type>article</type><title>Increased healthcare burden and comorbidity risks of pediatric patients with dystrophic epidermolysis bullosa: Analysis of Nationwide Emergency Department Sample 2015–2019</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Molnar, Brenda Abreu ; Yang, Lynna J. ; Paller, Amy S. ; Ren, Ziyou</creator><creatorcontrib>Molnar, Brenda Abreu ; Yang, Lynna J. ; Paller, Amy S. ; Ren, Ziyou</creatorcontrib><description>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.</description><identifier>ISSN: 0736-8046</identifier><identifier>ISSN: 1525-1470</identifier><identifier>EISSN: 1525-1470</identifier><identifier>DOI: 10.1111/pde.15688</identifier><identifier>PMID: 39049693</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Bone marrow transplantation ; Cardiomyopathy ; Cellulitis ; comorbidities ; Comorbidity ; Constipation ; Diagnosis ; Dystrophic epidermolysis bullosa ; emergency department ; Emergency medical care ; Epidermolysis bullosa ; Gastroesophageal reflux ; Genetic analysis ; Health care ; Nationwide Emergency Department Sample ; Patients ; pediatric dermatology ; Pediatrics ; Sepsis</subject><ispartof>Pediatric dermatology, 2024-09, Vol.41 (5), p.800-806</ispartof><rights>2024 The Author(s). published by Wiley Periodicals LLC.</rights><rights>2024 The Author(s). Pediatric Dermatology published by Wiley Periodicals LLC.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2788-eac1c231d62067d7b6b717a2ff5f16c9671b406771404638e265290030e9b6e13</cites><orcidid>0000-0001-7127-4197</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpde.15688$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpde.15688$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39049693$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Molnar, Brenda Abreu</creatorcontrib><creatorcontrib>Yang, Lynna J.</creatorcontrib><creatorcontrib>Paller, Amy S.</creatorcontrib><creatorcontrib>Ren, Ziyou</creatorcontrib><title>Increased healthcare burden and comorbidity risks of pediatric patients with dystrophic epidermolysis bullosa: Analysis of Nationwide Emergency Department Sample 2015–2019</title><title>Pediatric dermatology</title><addtitle>Pediatr Dermatol</addtitle><description>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.</description><subject>Bone marrow transplantation</subject><subject>Cardiomyopathy</subject><subject>Cellulitis</subject><subject>comorbidities</subject><subject>Comorbidity</subject><subject>Constipation</subject><subject>Diagnosis</subject><subject>Dystrophic epidermolysis bullosa</subject><subject>emergency department</subject><subject>Emergency medical care</subject><subject>Epidermolysis bullosa</subject><subject>Gastroesophageal reflux</subject><subject>Genetic analysis</subject><subject>Health care</subject><subject>Nationwide Emergency Department Sample</subject><subject>Patients</subject><subject>pediatric dermatology</subject><subject>Pediatrics</subject><subject>Sepsis</subject><issn>0736-8046</issn><issn>1525-1470</issn><issn>1525-1470</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kU9u1TAQhy1ERV8LCy6ALLGBRVpP_tgOu6p9hUpVQQLWkWNPeC5JHGxHT9lxB87RS3ESDCksKuHNSJ5vPmnmR8hzYCeQ3ulk8AQqLuUjsoEqrzIoBXtMNkwUPJOs5IfkKIRbxpjkHJ6Qw6JmZc3rYkPurkbtUQU0dIeqjzutPNJ29gZHqkZDtRucb62xcaHehq-Buo5OaKyK3mo6qWhxjIHubdxRs4To3bRLDZysQT-4fgk2JGHfu6De0LNRrT_JcpNm3bhPHN0O6L_gqBd6gZPycUhO-lENU480Z1D9_P4jlfopOehUH_DZfT0mny-3n87fZdfv316dn11nOhdSZqg06LwAw3PGhREtbwUIlXdd1QHXNRfQlqkjoEzHKSTmvMprxgqGdcsRimPyavVO3n2bMcRmsEFj36sR3RyagslScMmESOjLB-itm33aMlEAjNUAtUzU65XS3oXgsWsmbwfllwZY8zvDJmXY_MkwsS_ujXM7oPlH_g0tAacrsLc9Lv83NR8utqvyFx6_p-Q</recordid><startdate>202409</startdate><enddate>202409</enddate><creator>Molnar, Brenda Abreu</creator><creator>Yang, Lynna J.</creator><creator>Paller, Amy S.</creator><creator>Ren, Ziyou</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7127-4197</orcidid></search><sort><creationdate>202409</creationdate><title>Increased healthcare burden and comorbidity risks of pediatric patients with dystrophic epidermolysis bullosa: Analysis of Nationwide Emergency Department Sample 2015–2019</title><author>Molnar, Brenda Abreu ; Yang, Lynna J. ; Paller, Amy S. ; Ren, Ziyou</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2788-eac1c231d62067d7b6b717a2ff5f16c9671b406771404638e265290030e9b6e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Bone marrow transplantation</topic><topic>Cardiomyopathy</topic><topic>Cellulitis</topic><topic>comorbidities</topic><topic>Comorbidity</topic><topic>Constipation</topic><topic>Diagnosis</topic><topic>Dystrophic epidermolysis bullosa</topic><topic>emergency department</topic><topic>Emergency medical care</topic><topic>Epidermolysis bullosa</topic><topic>Gastroesophageal reflux</topic><topic>Genetic analysis</topic><topic>Health care</topic><topic>Nationwide Emergency Department Sample</topic><topic>Patients</topic><topic>pediatric dermatology</topic><topic>Pediatrics</topic><topic>Sepsis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Molnar, Brenda Abreu</creatorcontrib><creatorcontrib>Yang, Lynna J.</creatorcontrib><creatorcontrib>Paller, Amy S.</creatorcontrib><creatorcontrib>Ren, Ziyou</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Molnar, Brenda Abreu</au><au>Yang, Lynna J.</au><au>Paller, Amy S.</au><au>Ren, Ziyou</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased healthcare burden and comorbidity risks of pediatric patients with dystrophic epidermolysis bullosa: Analysis of Nationwide Emergency Department Sample 2015–2019</atitle><jtitle>Pediatric dermatology</jtitle><addtitle>Pediatr Dermatol</addtitle><date>2024-09</date><risdate>2024</risdate><volume>41</volume><issue>5</issue><spage>800</spage><epage>806</epage><pages>800-806</pages><issn>0736-8046</issn><issn>1525-1470</issn><eissn>1525-1470</eissn><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.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>39049693</pmid><doi>10.1111/pde.15688</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7127-4197</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bone marrow transplantation Cardiomyopathy Cellulitis comorbidities Comorbidity Constipation Diagnosis Dystrophic epidermolysis bullosa emergency department Emergency medical care Epidermolysis bullosa Gastroesophageal reflux Genetic analysis Health care Nationwide Emergency Department Sample Patients pediatric dermatology Pediatrics Sepsis |
| title | Increased healthcare burden and comorbidity risks of pediatric patients with dystrophic epidermolysis bullosa: Analysis of Nationwide Emergency Department Sample 2015–2019 |
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