Longitudinal trends of systemic lupus erythematous hospitalizations in the United States: a two-decade population-based study.

BACKGROUND: Longitudinal data are limited on systemic lupus erythematosus (SLE) hospitalizations. We aim to study longitudinal trends of SLE hospitalizations in the last 2 decades in the United States (U.S). METHODS: Data were obtained from the National Inpatient Sample database (NIS). We performed a 21-year longitudinal trend analysis of NIS 1998-2018. We searched for hospitalizations for adult patients with a "principal" diagnosis of SLE (SLE flare group) and those with "any" diagnosis of SLE (all SLE hospitalization group) using ICD codes. All non-SLE hospitalizations for adult patients were used as the control. Multivariable logistic and linear regression were used appropriately to calculate adjusted p-trend for the outcomes of interest. RESULTS: Incidence of SLE flare hospitalization reduced from 4.1 to 3.2 per 100,000 U.S persons from 1998 to 2018 (adjusted p-trend < 0.0001). The proportion of all hospitalized patients with SLE admitted principally for SLE reduced from 11.3% in 1998 to 5.7% in 2018 (adjusted p-tend < 0.0001). The proportion of hospitalized blacks in the SLE flare and all SLE hospitalization groups increased from 37.7% and 26.9% in 1998 to 44.7% and 30.7% in 2018 respectively (adjusted p-trend < 0.0001). The proportion of hospitalized Hispanics and Asians disproportionally increased in SLE flare hospitalizations compared to the control group. CONCLUSION: The incidence of hospitalization for SLE flare has reduced in the last 2 decades in the U.S. The proportion of hospitalized patients with SLE admitted principally for SLE has reduced significantly over time. However, the burden of SLE hospitalizations among ethnic minorities has increased over time. Key Points • The incidence of hospitalization for SLE flare has reduced in the last 2 decades in the U.S. • The proportion of hospitalized patients with SLE admitted principally for SLE has reduced significantly over time. • The burden of SLE hospitalizations among ethnic minorities such as blacks has increased over time.

Emergency Department Utilization by Patients With Eating Disorders: A National Population-Based Study.

Background There is a scarcity of national United States (U.S) data on emergency department (ED) utilization by patients with eating disorders. This study aims to determine the most common reasons for ED visits of patients with eating disorders, as well as baseline characteristics of patients who present due to eating disorders. Methods We obtained data from the Nationwide Emergency Department Sample (NEDS), the largest all-payer ED database in the United States. Each ED visit in NEDS 2018 can have only one "principal" diagnosis, which is the main reason for the visit and up to 34 "secondary" diagnoses. We abstracted data for all ED visits with "any" diagnosis of an eating disorder, using the ICD-10 code "F50". We highlighted the 10 most common "principal" diagnoses based on the organ system involved and the 10 most specific "principal" diagnoses for all ED visits by patients with any diagnosis of eating disorder. We then highlighted baseline characteristics of ED visits with a "principal" diagnosis of an eating disorder. Results There were a total of 56,901 ED visits for patients with eating disorders in 2018. Among these, 7,979 had an eating disorder as the "principal" diagnosis. Patients who visited the ED principally for eating disorders were more likely to be young females and came from higher-income households; about a third were admitted with 22.1 million U.S. dollars in aggregate ED charges. Mental disorders, and injuries and poisoning were the most common principal diagnosis by organ system categories, while eating disorders, major depression disorder (MDD), hypokalemia, and dehydration are common specific reasons for ED visits among patients with eating disorders. Conclusions Eating disorders, and its medical complications and psychiatric comorbidities such as MDD are common reasons for ED visits among patients with eating disorders. Management of the underlying eating disorder and their psychiatric comorbidities through a multidisciplinary approach in the outpatient setting is invaluable in reducing ED utilization by these patients.