Increases in One-year Mortality Risk Among Chronic Skin Ulcer Patients During the Period 1980-2020

Area of Science:

• Vascular Medicine
• Dermatology
• Public Health

Background:

• Chronic ulcers are associated with significant comorbidities and elevated mortality risk.
• Understanding short-term mortality in diverse ulcer types is critical for patient management.

Purpose of the Study:

• To investigate the short-term mortality risk in patients with various chronic ulcer types.
• To analyze trends in mortality risk over four decades (1980-2020).

Main Methods:

• Retrospective cohort study of 5,230 ulcer patients and 15,594 matched references.
• Hazard risks (HR) for mortality were compared across ulcer types (venous, arterial, mixed, vasculitic, pyoderma gangrenosum) and time periods.

Main Results:

• Overall 1-year mortality HR for ulcer patients was 3.8, highest for vasculitic (8.5), arterial (7.0), and pyoderma gangrenosum (6.6) ulcers.
• Mortality HR for all ulcer patients increased from 2.3 to 4.9 across the four decades.
• Diabetes (HR 31.6) and sepsis (HR 22.1) showed the highest mortality risks from underlying and immediate causes, respectively.

Conclusions:

• Chronic ulcer patients face a substantially increased 1-year mortality risk, which has risen over time.
• Specific ulcer types like vasculitic and pyoderma gangrenosum ulcers, along with comorbidities like diabetes and sepsis, significantly contribute to mortality.
• A multidisciplinary approach and robust management of underlying conditions are essential for reducing mortality in chronic ulcer patients.