Patient characteristics and outcomes of emergency visits in psoriatic arthritis: results from the U.S. Nationwide Emergency Department Sample.

OBJECTIVES

To evaluate patient characteristics and outcomes associated with emergency department (ED) visits in psoriatic arthritis (PsA) using the Nationwide Emergency Department Sample (NEDS), the largest all-payer U.S. ED database.

METHODS

We analyzed 2019 NEDS data for adults aged ≥ 18 years with and without PsA per International Classification of Diseases (ICD) codes. Baseline demographics, clinical comorbidities, and primary ED diagnoses were compared between PsA and non-PsA ED visits cross-sectionally. We assessed the top three primary diagnoses associated with inpatient admission among PsA ED visits. Pearson chi squared tests were used to compare categorical variables and t-tests to compare continuous variables. Multivariable logistic regression was used to identify factors associated with inpatient admission.

RESULTS

Among 117,359,429 ED visits, 61,079 (0.05%) involved PsA patients (mean age 58.9 ± 15.2 years, 59.6% female, 84.2% non-Hispanic White, 47.4% Medicare-insured). Compared to non-PsA visits, PsA visits involved older patients, higher Medicare usage (30.1% vs. 47.4%), and a greater admission frequency (54.6% vs. 17.0%). Top diagnoses linked to admission in PsA patients were septicemia, skin and subcutaneous infections, and heart failure. Factors increasing the odds of admission included older age (OR 1.02, 95% CI 1.02-1.03), alcohol use disorders (OR 3.43, CI 2.67-4.41), chronic kidney disease (OR 2.23, CI 1.89-2.64), obesity (OR 2.32, CI 2.05-2.64), and stroke (OR 4.83, CI 3.02-7.72).

CONCLUSION

PsA ED visits were characterized by older, non-Hispanic White patients, with over half requiring admission. Differences in age and comorbidity burden between patients with and without PsA may explain some of the findings. Key Points • We used a large U.S. database to assess ED utilization and outcomes in PsA patients. • Older age, comorbidities, and socioeconomic factors influence inpatient admission odds in patients with PsA. • Findings highlight health disparities, emphasizing the need for interventions to improve PsA patient outcomes.