Background/Purpose:: Psoriatic arthritis is a seronegative inflammatory arthritis associated with Psoriasis. Using the National Inpatient Sample (NIS) we studied the epidemiological characteristics of inpatients admissions using the ICD 9 Code 6460.00 in the year 2014.

Methods:: The NIS is a nationally representative sample of 20% of all non-federal hospitals in the USA with information from approximately 1000 hospitals pertaining to records from 7 million inpatient hospital admissions. The epidemiological characteristics we studied were age, gender, payer (Medicare/Medicaid/private insurance/uninsured), patient residence (large central metro, suburbs, medium and small metro and rural areas) and region (northeast, mid-west, southern and west) and associated co-morbidities: hypertension,diabetes,heart failure, chronic kidney disease,osteoarthritis & heart failure. Multiple linear regression was used to analyze factors that were associated with psoriatic arthritis.

Results: For 2014, from a total of nearly 7 million records (7,071,762), there were 775 admissions for psoriatic arthritis as the primary diagnosis (0.16%) which translated to 0.2 admissions per 100,000 persons.The majority of admissions were in the age group of 45 – 64 years (37.4 %) followed by 18-44 age group (30.9%). There was no gender difference males(52.9%) and females (47.1%) [p<0.4]. The total aggregate costs were $30,851,867 for 2014 amounting to a mean of $10,728 per admission. Medicare remained the highest payer (36.7%) followed by private insurance (33.5%) and finally Medicaid (21.9%). Patients from a 27.7% patients were from a large central metro and medium and small sized metro and an equal percentage of 27.7% were from a medium sized metro. 26.4% % of patients were from the suburbs and whereas only 18% were from a rural area.The southern region accounted for majority of admissions(34.%)followed by northeast region(25.1%).21.2% were from Midwest and Western region had only 19.3% of all admissions. The mean length of stay(LOS)was 4.4 ± 0.3 days. By multivariate regression the following co-morbidities were noted to be associated with psoriatic arthritis: Hypertension (p< 0.001), CKD (p<0.001), Osteoarthritis (p<0.001), Diabetes (p<0.001) and Heartfailure (p<0.001)

Conclusion: While psoriatic arthritis inpatient admissions only account for 0.2 per 100,000 persons, it places a significant burden on cost and length of stay and is independently associated with hypertension, CKD, osteoarthritis, diabetes and heart failure.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/epidemiological-characterisitics-of-psoriatric-arthritis-a-nationwide-study-of-inpatient-hospitalisations-in-2014/