title: Increased risk for cardiovascular mortality in psoriasis inpatients but not in outpatients.
abstract: We have conducted a historical cohort study to assess cardiovascular mortality among psoriasis patients. Using the Swedish Inpatient Registry, we selected 8991 patients hospitalized for psoriasis at dermatological wards. To represent an outpatient cohort, 19,757 members of the Swedish Psoriasis Association were selected. Mortality from cardiovascular diseases was compared with the general population. We found no increased cardiovascular mortality among outpatients with psoriasis (standardized mortality ratio, SMR 0.94; 95% confidence interval, CI: 0.89-0.99). The overall risk among inpatients admitted at least once was increased by 50% (SMR 1.52; 95% CI: 1.44-1.60). The excess risk increased with increasing number of hospital admissions (p for trend <0.001). Cardiovascular mortality was higher among those admitted at younger ages (p for trend <0.001; SMR 2.62, 95% CI: 1.91-3.49, for patients aged 20 to 39 years at first admission). Young age at first admission appeared to further increase the risk among those who were repeatedly admitted. We conclude that a diagnosis of psoriasis per se does not appear to increase the risk for cardiovascular mortality. Severe psoriasis, however, here measured as repeated admissions, and early age at first admission, is associated with increased risk for cardiovascular death.
authors.affiliation: Dermatology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden. lotus.mallbris@medks.ki.se
authors.forename: Lotus
authors.initials: L
authors.lastname: Mallbris
authors.forename: Olof
authors.initials: O
authors.lastname: Akre
authors.forename: Fredrik
authors.initials: F
authors.lastname: Granath
authors.forename: Li
authors.initials: L
authors.lastname: Yin
authors.forename: Bernt
authors.initials: B
authors.lastname: Lindelöf
authors.forename: Anders
authors.initials: A
authors.lastname: Ekbom
authors.forename: Mona
authors.initials: M
authors.lastname: Ståhle-Bäckdahl
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011565:Psoriasis / Q000150:complications*; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology