Severe atopic eczema ups mortality risk in adults

Very severe and predominantly active atopic eczema seems to increase mortality risk among adults, a recent study has found.

The researchers conducted a population-based matched cohort study including 526,736 atopic eczema patients (median age 42.3 years, 58.5 percent women) and 2,567,872 matched controls (median age 41.7 years, 58.0 percent women). Participants were followed for a median of 4.5 years.

Cox regression analysis revealed limited evidence of an association between atopic eczema and all-cause mortality (hazard ratio [HR], 1.04, 99 percent confidence interval [CI], 1.03–1.06), though there seemed to be signals of interaction with infections (HR, 1.14, 99 percent CI, 0.98–1.32), digestive diseases (HR, 1.11, 99 percent CI, 1.03–1.19), and diseases of the genitourinary system (HR, 1.08, 99 percent CI, 0.96–1.20).

Notably, the researchers detected a potential mediating effect of disease severity. Of the participants, 34,610 patients, corresponding to 187,910 years of follow-up time, were deemed to have severe atopic eczema, of whom 4,446 died.

Statistical analysis showed significant interactions between death due to various causes and severe vs no atopic eczema. For example, deaths due to infections were nearly three times as likely to occur among patients with severe disease (HR, 2.85, 99 percent CI, 1.78–4.55).

Moreover, deaths due to respiratory (HR, 2.20, 99 percent CI, 1.91–2.53) and genitourinary (HR, 2.10, 99 percent CI, 1.43–3.07) diseases were more than twice as likely in those with severe disease. The risk of all-cause death was raised by over 60 percent (HR, 1.62, 99 percent CI, 1.54–1.71).