Cause-specific mortality in patients with severe psoriasis: a population-based cohort study in the U.K.
Cause-specific mortality in patients with severe psoriasis: a population-based cohort study in the U.K.
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DOI：
10.1111/j.1365-2133.2010.09941.x
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Gelfand JM
中科院分区：
文献类型：
--
作者：
Abuabara K;Azfar RS;Shin DB;Neimann AL;Troxel AB;Gelfand JM
重度银屑病与死亡率过高和心血管死亡风险增加相关。评估银屑病患者病因特异性死亡率的基于人群的数据有限。描述重度银屑病患者的病因特异性死亡率。我们使用全科医学研究数据库对1987-2002年≥18岁的患者进行了一项队列研究。我们比较了具有银屑病编码和与重度银屑病一致的系统治疗史的患者（N= 3，603）与无银屑病史的患者（N= 14，330）。针对疾病控制中心定义的每一种主要死亡原因，建立了经性别和年龄调整的考克斯模型。重度银屑病患者死于心血管疾病的风险增加（HR 1.57; 95%CI 1.26-1.96），恶性肿瘤（HR 1.41; 95%CI 1.07-1.86），慢性下呼吸道疾病（HR 2.08; 95%CI 1.24-3.48），糖尿病（HR 2.86; 95%CI 1.08-7.59），痴呆（HR 3.64; 95%CI 1.36-9.72）、感染（HR 1.65; 95%CI 1.26-2.18）、肾脏疾病（HR 4.37; 95%CI 2.24-8.53）和未知/缺失原因（HR 1.44; 95%CI 1.09-1.88）。心血管疾病的绝对和超额死亡风险最高（分别为61.9和3.5例死亡/1000患者-年）。重度银屑病与多种原因导致的死亡风险增加相关，其中心血管死亡是最常见的病因。这些患者也有增加的死亡风险，原因是以前没有报道过的，如感染，肾脏疾病和痴呆。需要进一步的研究来确定银屑病、其治疗、相关行为或其他因素导致死亡的程度。
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. To describe cause-specific mortality in patients with severe psoriasis. 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. 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). 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.
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影响因子：
120.7
作者：
Gelfand, Joel M.;Neimann, Andrea L.;Troxel, Andrea B.
通讯作者：
Troxel, Andrea B.
影响因子：
--
作者：
Grossman, RM;Chevret, S;Dubertret, L
通讯作者：
Dubertret, L
影响因子：
--
作者：
Dickstein, Dara L.;Walsh, Jessica;Brautigam, Hannah;Stockton, Steven D., Jr.;Gandy, Samuel;Hof, Patrick R.
通讯作者：
Hof, Patrick R.
影响因子：
3.6
作者：
Dommasch, Erica;Gelfand, Joel M.
通讯作者：
Gelfand, Joel M.
影响因子：
3.4
作者：
Herrett, Emily;Thomas, Sara L.;Hall, Andrew J.
通讯作者：
Hall, Andrew J.