Clinical Characteristics and Outcomes of Patients Hospitalized with Epidermolysis Bullosa: A Retrospective Population-Based Observational Study in Spain (2016–2021)

Author:

Cuadrado-Corrales Natividad1ORCID,Lopez-de-Andres Ana1ORCID,Hernández-Barrera Valentín2,Carabantes-Alarcon David1ORCID,Zamorano-Leon Jose J.1,Omaña-Palanco Ricardo1,Del-Barrio Jose L.2,De-Miguel-Díez Javier3ORCID,Jimenez-Garcia Rodrigo1ORCID,Montoya Juan J.4ORCID

Affiliation:

1. Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain

2. Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, 28922 Madrid, Spain

3. Respiratory Care Department, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, 28007 Madrid, Spain

4. Faculty of Medicine, School of Sport Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain

Abstract

(1) Background: Epidermolysis bullosa (EB) comprises a group of rare skin diseases. We assessed diagnostic procedures, comorbidity profiles, length of hospital stay (LOHS), costs, and in-hospital mortality (IHM) associated with EB. (2) Methods: A retrospective, population-based observational study was performed using the Spanish National Hospital Discharge Database. Hospitalized patients with EB in Spain were identified for the period 2016 to 2021. (3) Results: A total of 677 hospitalizations were identified among 342 patients with a diagnosis of EB. Fifty percent of patients had at least one readmission during the 6-year follow-up. Notably, rehospitalizations were more common among patients aged 2–17 years. The most prevalent comorbidity was digestive disorders, which were associated with the frequency of esophageal dilatation procedures and percutaneous endoscopic gastrostomy. The longest LOHS was recorded for the 0- to 1-year age group. IHM increased with age, and the difference was statistically significant. The prevalence of malignant neoplasm was 36.88%, with cutaneous squamous cell carcinoma being the most frequent. The overall cost per hospitalized patient was estimated to be EUR 10,895.22 (SD EUR 13,394.81), with significant variations between age groups. (4) Conclusions: Readmissions are very frequent among people with EB. We observed a higher LOHS in the 0- to 1-year age group, while the highest rates of IHM were observed in patients older than 50 years. There was a substantial prevalence of comorbidities, namely, digestive disorders, infectious diseases, and especially cancer.

Funder

Madrid Government

Universidad Complutense de Madrid

Publisher

MDPI AG

Subject

General Biochemistry, Genetics and Molecular Biology,Medicine (miscellaneous)

Reference33 articles.

1. European Commission (2023, August 05). Implementation Report on the Commission Communication on Rare Diseases: Europe’s Challenges [COM (2008) 679 Final] and Council Recommendation of 8 June 2009 on an Action in the Field of Rare Diseases (2009/C 151/02) 2014. Available online: https://health.ec.europa.eu/system/files/2016-11/2014_rarediseases_implementationreport_en_0.pdf.

2. Why rare diseases are an important medical and social issue;Schieppati;Lancet,2008

3. Mapping health care of rare diseases: The example of epidermolysis bullosa in Germany;Reimer;Orphanet J. Rare Dis.,2018

4. Validity of first-time diagnoses of congenital epidermolysis bullosa in the Danish National Patient Registry and the Danish Pathology Registry;Kristensen;Clin. Epidemiol.,2019

5. Inherited epidermolysis bullosa: Update on the clinical and genetic aspects;Mariath;An. Bras. Dermatol.,2020

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