Bullous Pemphigoid-Associated Mortality Rate in a Canadian Tertiary Referral Centre

Area of Science:

• Dermatology
• Geriatrics
• Epidemiology

Background:

• Bullous pemphigoid (BP) is the most common autoimmune blistering disease in adults, predominantly affecting those over 60.
• Global incidence is rising due to population aging, with significant, variable mortality rates reported internationally.
• Canadian population data on BP mortality and risk factors were previously lacking.

Purpose of the Study:

• To determine the 12- and 24-month overall mortality rates for Canadian patients diagnosed with bullous pemphigoid.
• To identify independent risk factors associated with adverse outcomes in this patient cohort.

Main Methods:

• A retrospective cohort study involving 166 bullous pemphigoid patients from 2010-2020 at a tertiary referral center.
• Kaplan-Meier estimator was used for cumulative mortality calculations.
• Cox proportional hazards regression model identified independent prognostic factors.

Main Results:

• The study cohort had a median age of 79.1 years, with 48.2% aged 80 or older.
• Twelve-month mortality was 16.2% (CI95% = 10.5 - 21.8) and 24-month mortality was 27.6% (CI95% = 20.5 - 34.7).
• Male sex, age 80+, and major neurocognitive disorders were independently associated with poorer overall survival.

Conclusions:

• The observed mortality rates in Canadian bullous pemphigoid patients were comparable to international findings.
• Identifying high-risk patient groups (male, elderly, neurocognitive impairment) can inform clinical management and prognosis.