Patient-Specific factors associated with emergency department visits for flares in patients with hidradenitis suppurativa: a case-control study

Abstract

Adults with hidradenitis suppurativa (HS) often present to the Emergency Department (ED) for flare management despite long waits and non-dermatologic expertise. A case-control study was conducted at a US academic medical center to identify patient-specific factors contributing to ED visits for HS flares. The study included 676 HS patients who visited either the ED or dermatology clinic for an HS flare. Patient-level data was collected including demographics, socioeconomic factors, HS treatments, disease severity, and comorbidities. The primary outcome was ED visit for HS flare. Multivariable logistic regression was used to identify risk factors for ED visits. Of 676 flaring patients, 394 presented to the dermatology clinic and 283 to the ED. ED patients were younger, more likely to identify as Black (35.3% vs. 30%, p < 0.001), be publicly insured (26.9% vs. 15.3%, p < 0.001), and have prior ED use (OR = 1.73, 95% CI 1.42–2.12) versus clinic patients. Repeat ED visits were associated with male gender (OR = 1.21, 95% CI 1.01–1.45) and ED visits for other reasons (OR = 1.13, 95% CI 1.07–1.18). In sum, this study identifies patient-specific factors driving ED visits for HS flares, providing a more nuanced understanding of patients at higher risk for ED presentation, and highlighting potential opportunities to improve patient outcomes.