Clinical characteristics, hospital days, hospitalization costs, and in-hospital mortality among patients in a dermatological intensive care unit: a single-center retrospective study from China

Background Dermatological conditions can become extremely serious and cause life-threatening situations for affected patients, thereby necessitating intensive care. However, data from the dermatology intensive care unit (DICU) remain limited. This study aimed to describe the clinical characteristics, hospitalization duration, economic burden, and in-hospital mortality rate of DICU patients. Methods A retrospective analysis of electronic medical records from July 2017 to September 2023 for patients admitted to the DICU at Huashan Hospital, one of the largest tertiary hospitals and the only dermatology department equipped with the DICU in China, was performed. The data collected included demographics, diagnoses, hospital stays, and costs. The Mann‒Whitney U test and Kruskal‒Wallis test were used for statistical analysis when two or more groups were compared. Multiple stepwise linear regression was used to identify the main factors influencing hospital stay and costs. Results A total of 825 patients were analyzed. The median (interquartile range [IQR]) age was 60.0 (43.0–72.0) years, with a predominance of patients aged 60–79 years (40.5%) and a male-to-female ratio of 1.4. The most common diagnoses were severe cutaneous adverse reactions to drugs (29.2%), bullous skin diseases (18.4%), and psoriasis (16.5%). The overall in-hospital mortality rate was 0.36%. The median (IQR) hospital stay was 11.0 (7.0–15.0) days, and the median (IQR) total cost per patient was $4196 ($2655–7278). In the multiple stepwise linear regression model, factors mainly influencing hospital stays included comorbidity number and comorbidity type, especially pulmonary infection, bloodstream infection, and hypoproteinaemia. Factors mainly influenced total hospitalization cost were hospital stay, drug costs and comorbidity type, particularly gastrointestinal disorders, electrolyte abnormalities, venous thrombosis, skin infection, and bloodstream infection. Conclusions This study provides insights into the clinical characteristics, outcomes, and economic implications of managing severe primary dermatological conditions in patients in an intensive care setting and highlights the impact of comorbidities on hospitalization duration and costs.