Atopic eczema in adulthood and mortality: UK population-based cohort study, 1998-2016

Autor: Angel Y S Wong, Katrina Abuabara, Kathryn E. Mansfield, Amy Mulick, Sinead Langan, Richard J. Silverwood, Sigrún Alba Jóhannesdóttir Schmidt, Liam Smeeth, Amanda Roberts
Rok vydání: 2020
Předmět:
Male
Pediatrics
atopic eczema
severity
Cohort Studies
030207 dermatology & venereal diseases
Population based cohort
0302 clinical medicine
Cause of Death
electronic health care records
Immunology and Allergy
Medicine
030212 general & internal medicine
Atopic Dermatitis and Inflammatory Skin Disease
Aged
80 and over
education.field_of_study
United Kingdom/epidemiology
Mortality rate
Hazard ratio
ICD-10
Middle Aged
CPRD
Clinical Practice Research Datalink
HES
Hospital Episode Statistics
Female
ICD-10
International Classification of Diseases
10th Revision
GP
General practitioner
Cohort study
Adult
medicine.medical_specialty
Adolescent
Immunology
Population
Primary care
Dermatitis
Atopic
HR
Hazard ratio
03 medical and health sciences
Young Adult
primary care
cohort study
Humans
education
Aged
Dermatitis
Atopic/mortality
Genitourinary system
business.industry
ONS
Office for National Statistics
mortality
United Kingdom
Activity
population-based
body regions
IMD
Index of Multiple Deprivation
business
Zdroj: The Journal of Allergy and Clinical Immunology
Silverwood, R J, Mansfield, K E, Mulick, A, Wong, A Y S, Schmidt, S A J, Roberts, A, Smeeth, L, Abuabara, K & Langan, S M 2021, ' Atopic eczema in adulthood and mortality : UK population–based cohort study, 1998-2016 ', Journal of Allergy and Clinical Immunology, vol. 147, no. 5, pp. 1753-1763 . https://doi.org/10.1016/j.jaci.2020.12.001
Silverwood, R J, Mansfield, K E, Mulick, A, Wong, A Y S, Schmidt, S A J, Roberts, A, Smeeth, L, Abuabara, K & Langan, S M 2021, ' Atopic eczema in adulthood and mortality : UK population-based cohort study, 1998-2016 ', The Journal of allergy and clinical immunology, vol. 147, no. 5, pp. 1753-1763 . https://doi.org/10.1016/j.jaci.2020.12.001
ISSN: 1097-6825
0091-6749
Popis: BACKGROUND: Atopic eczema affects up to 10% of adults and is becoming more common globally. Few studies have assessed whether atopic eczema increases the risk of death.OBJECTIVE: We aimed to determine whether adults with atopic eczema were at increased risk of death overall and by specific causes and to assess whether the risk varied by atopic eczema severity and activity.METHODS: The study was a population-based matched cohort study using UK primary care electronic health care records from the Clinical Practice Research Datalink with linked hospitalization data from Hospital Episode Statistics and mortality data from the Office for National Statistics from 1998 to 2016.RESULTS: A total of 526,736 patients with atopic eczema were matched to 2,567,872 individuals without atopic eczema. The median age at entry was 41.8 years, and the median follow-up time was 4.5 years. There was limited evidence of increased hazard for all-cause mortality in those with atopic eczema (hazard ratio = 1.04; 99% CI = 1.03-1.06), but there were somewhat stronger associations (8%-14% increased hazard) for deaths due to infectious, digestive, and genitourinary causes. Differences on the absolute scale were modest owing to low overall mortality rates. Mortality risk increased markedly with eczema severity and activity. For example, patients with severe atopic eczema had a 62% increased hazard (hazard ratio = 1.62; 99% CI = 1.54-1.71) for mortality compared with those without eczema, with the strongest associations for infectious, respiratory, and genitourinary causes.CONCLUSION: The increased hazards for all-cause and cause-specific mortality were largely restricted to those with the most severe or predominantly active atopic eczema. Understanding the reasons for these increased hazards for mortality is an urgent priority.
Databáze: OpenAIRE
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