Cause-specific mortality in patients with severe psoriasis: A population-based cohort study in the United Kingdom.
Summary of "Cause-specific mortality in patients with severe psoriasis: A population-based cohort study in the United Kingdom."
Abstract Background: Severe psoriasis is associated with excess mortality and increased risk of cardiovascular death. Population-based data evaluating cause-specific mortality in patients with psoriasis are limited. Objective: To describe cause-specific mortality in patients with severe psoriasis. Patients/Methods: We performed a cohort study from 1987-2002 of patients >18 years using the General Practice Research Database. We compared patients with a psoriasis code and a history of systemic therapy consistent with severe psoriasis (N=3,603) to patients with no history of psoriasis (N=14,330). Age- and sex-adjusted Cox models were created for each of the leading causes of death defined by the Centers for Disease Control. Results: Patients with severe psoriasis were at increased risk of death from cardiovascular disease (HR 1.57; 95%CI 1.26-1.96), malignancies (HR 1.41; 95%CI 1.07-1.86), chronic lower respiratory disease (HR 2.08; 95%CI 1.24-3.48), diabetes (HR 2.86; 95%CI 1.08-7.59), dementia (HR 3.64; 95%CI 1.36-9.72), infection (HR 1.65; 95%CI 1.26-2.18), kidney disease (HR 4.37; 95%CI 2.24-8.53), and unknown/missing causes (HR 1.44; 95%CI 1.09-1.88). The absolute and excess risk of death was highest for cardiovascular disease (61.9 and 3.5 deaths per 1000 patient-years respectively). Conclusions: Severe psoriasis is associated with an increased risk of death from a variety of causes with cardiovascular death being the most common etiology. These patients were also at increased risk of death from causes not previously reported such as infection, kidney disease, and dementia. Additional studies are necessary to determine the degree to which excess causes of death are due to psoriasis, its treatments, associated behaviors, or other factors.
Affiliation
Department of Dermatology, University of Pennsylvania, Philadelphia, PA.
Journal Details
This article was published in the following journal.
Name: The British journal of dermatology
ISSN: 1365-2133
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20633008
- DOI: http://dx.doi.org/10.1111/j.1365-2133.2010.09941.x
Medical and Biotech [MESH] Definitions
Age Distribution
The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.
Sex Distribution
The number of males and females in a given population. The distribution may refer to how many men or women or what proportion of either in the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.
Sentinel Surveillance
Monitoring of rate of occurrence of specific conditions to assess the stability or change in health levels of a population. It is also the study of disease rates in a specific cohort, geographic area, population subgroup, etc. to estimate trends in larger population. (From Last, Dictionary of Epidemiology, 2d ed)
Fetal Mortality
Number of fetal deaths with stated or presumed gestation of 20 weeks or more in a given population. Late fetal mortality is death after of 28 weeks or more.
Infant Mortality
Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth.
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