Background/Purpose: Given that uptake of biologic therapies has increased over recent years, we sought to investigate the national trends in serious infections in patients with psoriatic arthritis from the years 2012 – 2017 in the United States.

Methods: The NIS approximates a 20% stratified sample of all discharges from U.S. community hospitals, excluding rehabilitation and long-term acute care hospitals, with approximately 7 million discharge records. We examined data from 2012–2017 and identified any discharge diagnosis for PsA with a principal or secondary diagnosis of pneumonia, sepsis, urinary tract infection (UTI) and/or skin and soft tissue infections (SSTIs) using ICD-9 & ICD 10 codes. We standardized results for years 2012-2017 to match age distributions in the US population in the year 2012. We then tested for a trend over years 2012-2017 using chi squared tests, evaluating for an increase in serious infections over the years.

Results: For the year 2012, the mean age of discharged patients overall was 59.5 + 14.3 years. Females comprised 56% of discharged patients and Caucasians for 88.5%. The mean (SD) length of stay was 4.7 + 4.7 days. For the year 2017, the mean age for discharged patients overall was 60.8 + 14.1. Females accounted for 57.7% and Caucasians for 88.4 %. The mean (SD) length of stay was 4.9 + 5.8 days.

In the year 2012, there were a total of 50,700 discharge diagnoses of PsA, of which 125 patients had a diagnosis of pneumonia, 230 patients with sepsis, 312 patients with a skin and soft tissue infection and 174 patients with a urinary tract infection (UTI). For comparison in 2017, there were a total of 179,400 discharge diagnoses of PsA, of which 344 patients had pneumonia, 374 patients had sepsis, 681 patients had SSTI and 348 patients had UTI.

From 2012 – 2017 there was a statistically significant decrease in discharges for sepsis, skin and soft tissue infections and UTI (p < 0.001 for all) over the years after standardizing for age. There was no statistical difference in the trend of pneumonia between the years (p = 0.89).

Conclusion: Our data shows statistically significant decrease in sepsis, skin and soft tissue infections and UTI in patients with PsA despite the increased use of biologics over the years. There was no statistical difference in pneumonia discharges after standardizing for age.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/national-trends-in-hospitalizations-for-serious-infections-in-people-with-psoriatic-arthritis-using-the-national-inpatient-sample-2012-2017/