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Nationwide Assessment of Cause-Specific Mortality in Patients with Rosacea: A Cohort Study in Denmark

  • Original Research Article
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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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark

    Alexander Egeberg & Jacob P. Thyssen

  2. Division of Dermatology, University of Louisville, Louisville, KY, USA

    Joseph F. Fowler Jr.

  3. Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark

    Gunnar H. Gislason

  4. The Danish Heart Foundation, 1127, Copenhagen, Denmark

    Gunnar H. Gislason

  5. The National Institute of Public Health, University of Southern Denmark, 1353, Copenhagen, Denmark

    Gunnar H. Gislason

Authors
  1. Alexander Egeberg
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  2. Joseph F. Fowler Jr.
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  3. Gunnar H. Gislason
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  4. Jacob P. Thyssen
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Corresponding author

Correspondence to Alexander Egeberg.

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Author contributions

Drs. Egeberg and Gislason had full access to all of the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: Alexander Egeberg and Jacob Thyssen. Acquisition, analysis, and interpretation of data: Alexander Egeberg, Gunnar Gislason, and Jacob Thyssen. Drafting of the manuscript: Alexander Egeberg and Jacob Thyssen. Critical revision of the manuscript for important intellectual content: Alexander Egeberg, Joseph Fowler, Gunnar Gislason, and Jacob Thyssen. Statistical analysis: Alexander Egeberg and Gunnar Gislason. Obtained funding: Alexander Egeberg. Administrative, technical, or material support: Alexander Egeberg, Gunnar Gislason, and Jacob Thyssen. Study supervision: Alexander Egeberg, Gunnar Gislason, and Jacob Thyssen.

Conflicts of interest

Dr. Egeberg has received research funding and/or consultancy honoraria from Pfizer and Eli Lilly. Dr. Gislason is supported by an unrestricted research scholarship from the Novo Nordisk Foundation, and reports research grants from Pfizer, Bristol–Myers Squibb, AstraZeneca, Bayer and Boehringer Ingelheim. Dr. Thyssen is supported by an unrestricted grant from the Lundbeck foundation, and has received consultancy and/or speaker honoraria from Galderma and MEDA. Dr Fowler has no conflicts of interest to declare.

Funding

No funding was received for the conduct of this study or the preparation of the manuscript.

Ethical approval

The study was approved by the Danish Data Protection agency (ref. 2007-58-0015, int. ref. GEH-2014-018, I-suite 02736), and, in Denmark, register studies do not require approval from an ethical committee.

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Egeberg, A., Fowler, J.F., Gislason, G.H. et al. Nationwide Assessment of Cause-Specific Mortality in Patients with Rosacea: A Cohort Study in Denmark. Am J Clin Dermatol 17, 673–679 (2016). https://doi.org/10.1007/s40257-016-0217-1

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  • DOI: https://doi.org/10.1007/s40257-016-0217-1

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