Noncutaneous Infections in Patients with Hidradenitis Suppurativa: A Retrospective Cohort Study

Adults with hidradenitis suppurativa (HS) have comorbidities and are exposed to treatments that may increase their risk of serious infections. Therefore, our study aims to determine the prevalence and risk factors for noncutaneous infections (NCIs) related hospitalizations in adults with HS and analyze their patterns of healthcare utilization. This retrospective cohort included patients with dermatologist-confirmed HS from a single healthcare system between 2018 and 2022. Primary/secondary diagnostic codes identified NCI-related hospitalizations. Multivariable logistic regression assessed risk factors. Data on nonpsychiatric hospitalizations and emergency department visits were collected for overall healthcare utilization. Among the 834 patients with HS, 6.4% were hospitalized for NCI during the study period. The most common infections were urinary tract infections (18.2%), musculoskeletal infections (13%), and COVID-19 (11.7%). The main factors associated with NCIs were public insurance (OR = 2.06, confidence interval = 1.09-3.83), chronic kidney disease (OR = 7.73, confidence interval = 2.03-29.09), and anxiety (OR = 3.27, confidence interval = 1.58-6.67). Prevalence of nonpsychiatric hospitalization was 24.6%, and that of emergency department visits was 45.3%. In conclusion, patients with HS had a significant prevalence of hospitalizations from NCIs, with urinary tract infections being the most prevalent. The risk was higher in patients with anxiety or chronic kidney disease. Future research should focus on interventions and measures to prevent infections.