The journal of allergy and clinical immunology. Global · 2026
Nationwide analysis of temporal trends and outcomes in hospitalized patients with predominantly antibody deficiency using the National Inpatient Sample.
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Elmoursi Ahmed, Zhang Lingxiao, Barmettler Sara
Аннотация
BACKGROUND: Predominantly antibody deficiency (PAD) is the most common inborn error of immunity and is associated with increased susceptibility to infections and noninfectious complications, yet we lack population-level data on the impact of this diagnosis on hospitalization outcomes.
OBJECTIVE: We conducted a nationwide analysis evaluating health care utilization and hospitalization outcomes among patients with PAD compared with non-PAD hospitalized patients, examining temporal trends and the impact of coronavirus disease 2019.
METHODS: We performed a cross-sectional analysis from 2017 to 2020 using the National Inpatient Sample, part of the Healthcare Cost and Utilization Project by the Agency for Healthcare Research and Quality. ICD-10 codes were used to identify PAD-associated admissions.
RESULTS: We identified 179,710 weighted PAD-associated and 108,933,035 non-PAD-associated hospitalizations. Compared with non-PAD admissions, PAD hospitalizations had higher total hospital costs ($13,961 vs $9,436), longer length of stay (5.0 vs 3.5 days), and higher in-hospital mortality (4.1% vs 2.7%; all P < .0001). In adjusted survey-weighted models, PAD remained independently associated with substantially higher costs and longer hospital stays, without increased odds of in-hospital mortality. Temporal analysis from 2017 to 2020 revealed increasing costs ($12,611 to $15,373), length of stay (4.4 to 4.6 days), and in-hospital mortality (3.8% to 4.5%; all P < .0001).
CONCLUSIONS: Patients with PAD had increased health care utilization and worse outcomes including in-hospital mortality. These burdens worsened over time, with the greatest escalation in 2020, partly reflecting coronavirus disease 2019-related hospitalizations. Further investigation is needed to identify underlying drivers and develop targeted strategies to improve outcomes in patients with PAD.
OBJECTIVE: We conducted a nationwide analysis evaluating health care utilization and hospitalization outcomes among patients with PAD compared with non-PAD hospitalized patients, examining temporal trends and the impact of coronavirus disease 2019.
METHODS: We performed a cross-sectional analysis from 2017 to 2020 using the National Inpatient Sample, part of the Healthcare Cost and Utilization Project by the Agency for Healthcare Research and Quality. ICD-10 codes were used to identify PAD-associated admissions.
RESULTS: We identified 179,710 weighted PAD-associated and 108,933,035 non-PAD-associated hospitalizations. Compared with non-PAD admissions, PAD hospitalizations had higher total hospital costs ($13,961 vs $9,436), longer length of stay (5.0 vs 3.5 days), and higher in-hospital mortality (4.1% vs 2.7%; all P < .0001). In adjusted survey-weighted models, PAD remained independently associated with substantially higher costs and longer hospital stays, without increased odds of in-hospital mortality. Temporal analysis from 2017 to 2020 revealed increasing costs ($12,611 to $15,373), length of stay (4.4 to 4.6 days), and in-hospital mortality (3.8% to 4.5%; all P < .0001).
CONCLUSIONS: Patients with PAD had increased health care utilization and worse outcomes including in-hospital mortality. These burdens worsened over time, with the greatest escalation in 2020, partly reflecting coronavirus disease 2019-related hospitalizations. Further investigation is needed to identify underlying drivers and develop targeted strategies to improve outcomes in patients with PAD.