Background

Little is known about the risk and predictors of autoimmune diseases in children and adults.

Objective

To determine the prevalence, predictors, and excess costs of autoimmune disease in atopic dermatitis (AD) patients.

Methods

Cross-sectional study of the 2002-2012 National Inpatient Sample, which includes a ∼20% sample of all US hospitalizations (n = 87,053,155 adults and children).

Results

The prevalence of autoimmune disease was higher in adults with AD (7.9%, 95% confidence interval [95% CI] 7.3-8.5%) than without AD (5.7%, 95% CI 5.7%-5.8%) and higher in children with AD (2.0%, 95% CI 1.7%-2.3%) than without AD (1.0%, 95% CI 0.9%-1.1%). In multivariable logistic regression models controlling for sociodemographics, adult (adjusted odds ratio 1.45, 95% CI 1.32-1.58) and pediatric (adjusted odds ratio 2.08, 95% CI 1.73-2.50) AD were associated with any autoimmune disorder. In particular, AD was associated with 18 of 32 autoimmune disorders examined in adults and 13 of 24 examined in children, including disorders of the skin, endocrine, gastrointestinal, hematologic, and musculoskeletal systems. AD patients hospitalized with any autoimmune disorder had a higher cost of inpatient care, with $2.5-$50 million excess annual costs.

Conclusions

Adults and children with AD had increased cutaneous and extracutaneous autoimmune disorders, which were associated with a considerable cost burden.

中文翻译：

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美国成年人和儿童特应性皮炎与自身免疫性疾病之间的关联：一项横断面研究

背景

关于儿童和成人自身免疫性疾病的风险和预测因素知之甚少。

客观的

为了确定特应性皮炎（AD）患者自身免疫性疾病的患病率，预测因素和超额费用。

方法

2002-2012年国家住院患者样本的横断面研究，其中包括美国所有住院病例的约20％（n = 87,053,155名成人和儿童）。

结果

患有AD的成人（7.9％，95％置信区间[95％CI] 7.3-8.5％）的成人自身免疫性疾病的患病率高于未患有AD的成人（5.7％，95％CI 5.7％-5.8％），而患有AD的儿童则更高AD（2.0％，95％CI 1.7％-2.3％）比没有AD（1.0％，95％CI 0.9％-1.1％）高。在控制社会人口统计学的多变量logistic回归模型中，成人（调整后的优势比为1.45，95％CI为1.32-1.58）和儿童（调整后的优势比为2.08，95％CI 1.73-2.50）AD与任何自身免疫性疾病相关。特别地，AD与成人检查的32种自身免疫疾病中的18种以及儿童检查的24种中13种相关，包括皮肤，内分泌，胃肠道，血液学和肌肉骨骼系统疾病。患有任何自身免疫性疾病的AD患者住院治疗的费用较高，每年的额外费用为2.5至5000万美元。

结论

成人和儿童AD的皮肤和皮肤外自身免疫性疾病增加，这与可观的成本负担相关。