All-cause mortality among patients with hidradenitis suppurativa: A population-based cohort study in the United States

Abstract

Background: The mortality risk for patients with hidradenitis suppurativa (HS) is largely unknown.

Objective: To compare mortality risk among individuals with and without HS in the United States.

Methods: Retrospective cohort study in a population sample identified by using electronic health records data between January 1, 2012, and December 31, 2016. Primary outcome was incidence of 5-year all-cause mortality.

Results: The crude 5-year mortality rate among patients with HS was 2.4% (321/13 289), compared with 2.7% (18 508/685 573) among control individuals. In the fully adjusted model, the increase in HS mortality risk was 14% (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.01-1.28). Overall, excess risk of death attributable to HS was 3.1 deaths per 1000 patients (95% CI, 0.2-6.0) during the study period. Characteristics associated with mortality among patients with HS included age (OR, 1.05; 95% CI, 1.04-1.06), male sex (OR, 1.40; 95% CI, 1.09-1.79), ever-smoking status (OR, 1.48; 95% CI, 1.16-1.92), and Charlson Comorbidity Index score (OR, 1.25; 95% CI, 1.21-1.29).

Limitations: The follow-up period may not have been long enough to assess the influence of disease severity or duration on mortality.

Conclusion: HS appears to confer an independent risk of all-cause mortality. This risk is also influenced by tobacco smoking and comorbidities, which may be modifiable.

Keywords: comorbidities; comorbidity; hidradenitis suppurativa; mortality.