Nationwide Analysis of Eosinophilic Granulomatosis With Polyangiitis Hospitalizations

To characterize adult hospitalizations for eosinophilic granulomatosis with polyangiitis (EGPA) in the United States and identify clinical and sociodemographic factors independently associated with in‑hospital mortality.

We conducted a retrospective analysis of the National Inpatient Sample Database (2016-2022) to identify adult EGPA hospitalizations. Demographics, comorbidities, complications, insurance type, income quartile, length of stay, and total charges were compared between survivors and nonsurvivors. Variables with p ≤ 0.2 in univariable analysis were entered into multivariable logistic regression to determine independent predictors of in‑hospital death.

Among 12,900 EGPA hospitalizations, 355 patients died (2.75%). Nonsurvivors were older, had longer hospitalizations, and incurred higher total hospital charges. In multivariable analysis, cardiac disease (OR: 1.94; 95% CI: 1.157-3.237), central nervous system (CNS) involvement (OR: 2.91; 95% CI: 1.004-8.453), gastrointestinal (GI) disease (OR: 3.05; 95% CI: 1.159-8.042), infection (OR: 3.87; 95% CI: 2.123-7.046), interstitial lung disease (OR: 2.62; 95% CI: 1.227-5.598), and renal disease (OR: 5.20; 95% CI: 2.784-9.708) were independently associated with in‑hospital mortality. Demographic and socioeconomic variables, including sex, race/ethnicity, insurance type, and income quartile, were not independent predictors of in-hospital death.

In this nationally representative cohort, in‑hospital mortality for EGPA was 2.75%. Renal, infectious, cardiac, CNS, GI, and pulmonary complications were strongly associated with death. These findings underscore the need for early recognition and aggressive management of organ‑threatening disease and infection in hospitalized EGPA patients.