Factors associated with prolonged hospital stay in patients with autoimmune bullous diseases treated at an in-patient dermatology service

Background Bullous diseases carry a great burden and are often linked to high healthcare costs. Patients with ­bullous diseases are more vulnerable to infections and organ damage due to an incompetent skin barrier. Objectives To determine the demographic, clinical and laboratory factors associated with prolonged hospital stay in patients with autoimmune bullous diseases. Methods This was a cross-sectional study, with a follow-up cohort, including all dermatology consultations in a university hospital between 2017 and 2022 to identify patients with autoimmune bullous disease. Duration of stay and other variables were obtained from the patients’ medical records. Results A total of 83 patients were included in the study, of whom the majority had bullous pemphigoid (n = 45; 54%). There was significant metabolic comorbidity with hypertension (n = 51; 61%), diabetes (n = 31; 37%) and dyslipidaemia (n = 31; 37%). Fifty-eight per cent of patients had a prolonged hospital stay (>10 days). Among the associated variables, mucosal involvement, eosinophilia, in-hospital antibiotics and the absence of dipetidyl peptidase-4 (DPP4) inhibitor use stood out. Conclusions Most patients with bullous diseases have prolonged hospital stays. The evaluation of mucous membranes, blood count and a basic chemical panel can help identify patients at greater risk of prolonged hospital stays. In addition, the use of DPP4 inhibitors and their rapid discontinuation could affect this outcome.