한빛사논문
- 조회478
Se Rim Choi,1* Anna Shin,1* You-Jung Ha,1,2 Yun Jong Lee,1,2 Eun Bong Lee,2,3 Eun-So Lee4 and Eun Ha Kang1,2
1Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
3Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
4Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
*Contributed equally
Se Rim Choi and Anna Shin Contributed equally.
Corresponding author: Eun Ha Kang, MD, PhD, MPH
Abstract
Background: Comparative risk regarding cause-specific mortality between patients with Behcet's disease (BD) and the general population is not known.
Objectives: To compare the risk of all-cause and cause-specific mortality among patients with BD versus the general population.
Methods: Using the 2002-2020 Korea National Health Insurance Service database, we conducted a cohort study comparing BD patients and the general population matched on age and sex at a 1:4 ratio. We used Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality. Subgroup analyses by age and sex were done.
Results: We included 24,669 BD patients and 98,676 age- and sex-matched controls (mean age 40.5 years, 34% male). During a mean follow-up of 11.9 years, the incidence rate of death per 100 person-years was 0.36 in BD and 0.29 in controls with the HR (95% CI) of 1.28 (1.20-1.38). The risk of mortality was highest for one year after BD diagnosis showing a HR (95% CI) of 2.66 (2.09-3.40). BD patients died more in this period due to malignancy, cardiovascular (CV), gastrointestinal, and respiratory disease, and infection: the corresponding cause-specific HR (95% CI) was 1.96 (1.30-2.98), 2.68 (1.45-4.97), 3.50 (1.35-9.07), 5.00 (1.34-18.62), and 3.33 (1.02-10.92), respectively. Mortality by neurological (HR 1.58, 95% CI 1.06-2.35) and genitourinary disease (HR 2.20, 95% CI 1.43-3.37) was also more common in BD during the overall follow-up. Subgroup analyses showed consistent results. The risk of CV mortality compared to the general population was higher in the young than elderly (p for interaction = 0.006), and the risk of gastrointestinal mortality in women than men (p for interaction = 0.04).
Conclusions: This population-based cohort study shows the first year of the disease as the highest risk window for excess mortality among BD patients. The mortality burden in BD derived from a wide spectrum of organ involvements, warning clinicians about the systemic nature of the disease.
논문정보
- Research article
- 2024년 02월 (BRIC 등록일 2024-02-20)
- 국내 연구진
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