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Psoriasis does not worsen outcomes in patients admitted for ischemic stroke: an analysis of the National Inpatient Sample
  1. Ehizogie Edigin1,
  2. Subuhi Kaul1,
  3. Precious Obehi Eseaton2,
  4. Pius Ehiremen Ojemolon3,
  5. Axi Patel1,
  6. Augustine Manadan4,5
  1. 1 Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
  2. 2 College of Medicine, University of Benin, Benin City, Edo, Nigeria
  3. 3 Anatomical Sciences, St George's University, St George's, Grenada
  4. 4 Rheumatology, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
  5. 5 Rheumatology, Rush University Medical Center, Chicago, Illinois, USA
  1. Correspondence to Dr Ehizogie Edigin, Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL 60612, USA; ediginehizogie{at}yahoo.com

Abstract

Psoriasis is a chronic inflammatory state associated with an increased risk of cardiometabolic diseases, stroke, and mortality. Although psoriasis increases the risk of ischemic stroke, whether outcomes, including mortality, are adversely affected is unknown.

This study aims to compare inpatient mortality of patients admitted for ischemic stroke with and without psoriasis. The secondary outcome measures were hospital length of stay (LOS), total hospital charges, odds of receiving tissue plasminogen activator (TPA), and mechanical thrombectomy between both groups.

Data were obtained from the National Inpatient Sample (NIS) 2016 and 2017 databases using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. Multivariable logistic and linear regression analysis were used accordingly to account for confounders of the outcomes.

The combined 2016 and 2017 NIS database comprised over 71 million discharges. Of these, ischemic stroke accounted for 525,570 hospitalizations and 2425 (0.5%) had a concomitant diagnosis of psoriasis. Patients hospitalized for ischemic stroke with coexisting psoriasis did not have a difference in inpatient mortality (3.5% vs 5.5%; p=0.285) compared with those without psoriasis. However, psoriasis cohort had shorter LOS (5.0 vs 5.7 days; p=0.029) and lower total hospital charges ($60,471 vs $70,246; p=0.003) compared with the non-psoriasis cohort. The odds of receiving TPA and undergoing mechanical thrombectomy were not different in both groups.

Inpatient mortality, odds of receiving TPA, and undergoing mechanical thrombectomy in patients who had an ischemic stroke with or without psoriasis were not different. However, patients with psoriasis had a significantly shorter LOS and lower hospital charges.

  • stroke
  • psoriasis
  • morbidity
  • hospital charges
  • biostatistics

Data availability statement

Data are available in a public, open access repository. Data were obtained from the National Inpatient Sample (NIS) database. The NIS is available at https://www.hcup-us.ahrq.gov/

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Data availability statement

Data are available in a public, open access repository. Data were obtained from the National Inpatient Sample (NIS) database. The NIS is available at https://www.hcup-us.ahrq.gov/

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Footnotes

  • Contributors EE and POE are credited with substantial contribution to the design of the work, acquisition and interpretation of data, drafting the manuscript, revision of important intellectual content, final approval of the version published, and agreement of accountability for all aspects of the work. SK and PEO are credited with substantial contribution to acquisition, analysis, and interpretation of data, revision of critically important intellectual content, final approval of the version to be published, and agreement of accountability for all aspects of the work. AP and AM are accredited with revision of critically important intellectual content, final approval of the version to be published, and agreement of accountability for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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