title: Nationwide Assessment of Cause-Specific Mortality in Patients with Rosacea: A Cohort Study in Denmark.
abstract: BACKGROUND
  Emerging data suggest that rosacea is associated with several comorbidities; however, the causes of mortality in patients with rosacea have not yet been investigated.
  
  
  OBJECTIVE
  We evaluated all-cause and cause-specific death rates in patients with rosacea in a population-based Danish cohort study.
  
  
  METHODS
  All Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2012 with rosacea diagnosed by hospital dermatologists were linked in nationwide registers and compared with age- and sex-matched general-population subjects (1:5 ratio). Death rates were calculated per 1000 person-years, and hazard ratios (HRs) were estimated using Cox regression models.
  
  
  RESULTS
  The total cohort (n = 35,958) included 5993 patients with rosacea and 29,965 age- and sex-matched individuals from the general population. During the maximum 15 years of follow-up, 664 (11.1 %) patients with rosacea and 3121 (10.4 %) patients in the reference population died. The risk of all-cause mortality was similar in patients with rosacea and the reference population [HR 1.06, 95 % confidence interval (CI) 0.98-1.15]. Analyses of cause-specific mortality revealed a significantly increased risk of death due to gastrointestinal diseases in patients with rosacea (HR 1.95, 95 % CI 1.31-2.89), primarily related to hepatic disease. No increased risk of death due to other major disease categories, e.g. cancer, cardiovascular, neurological, or infectious diseases was observed.
  
  
  CONCLUSIONS
  We observed a significantly increased risk of death due to gastrointestinal diseases (primarily hepatic disease) in patients with rosacea; however, we found no increased risk of death due to other causes such as cardiovascular or neurological diseases. Although this does not necessarily imply a causal link, the findings underscore the association between rosacea and gastrointestinal disease, but also that rosacea may be associated with increased risk factors, including alcohol consumption.
authors.affiliation: Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark. alexander.egeberg@gmail.com.
authors.forename: Alexander
authors.identifier: http://orcid.org/0000-0001-8257-1816
authors.initials: A
authors.lastname: Egeberg
authors.affiliation: Division of Dermatology, University of Louisville, Louisville, KY, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Fowler
authors.affiliation: Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark.|The Danish Heart Foundation, 1127, Copenhagen, Denmark.|The National Institute of Public Health, University of Southern Denmark, 1353, Copenhagen, Denmark.
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark.
authors.forename: Jacob P
authors.initials: JP
authors.lastname: Thyssen
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D012393:Rosacea / Q000453:epidemiology*