All-cause and cause-specific mortality in psoriasis patients: a systematic review and meta-analysis
Bibliographic record
Abstract
Objective: The objective of this meta-analysis is to assess the all-cause and cause-specific mortality in patients with psoriasis. Method: In accordance with PRISMA guidelines, a systematic search of PubMed, EMBASE, and the Cochrane Library (from inception to March 2025) was conducted. Eligible studies comprised English-language cohort studies comparing mortality risk (HR/OR/RR) in adults with psoriasis versus healthy/non-psoriasis controls. Two reviewers independently screened studies, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. Hazard ratios (HRs) were synthesized using random-effects models in Stata 14.0. Sensitivity analyses, subgroup analyses, and assessments of publication bias (via funnel plots and Egger's test) were also performed. Result: A total of 20 studies involving 8825989 participants were included. Psoriasis patients demonstrated significantly increased risks of all-cause mortality [HR=1.19, 95% CI (1.11-1.28), P=0.000], cardiovascular mortality [HR = 1.32, 95% CI (1.11-1.58), P = 0.002], infection-related mortality [HR=1.24, 95% CI (1.13-1.36), P=0.000], and suicide mortality [HR=1.50, 95% CI (1.03-2.19), P=0.034]. The risk of mortality due to neoplasms was marginally elevated but not statistically significant [HR=1.05, 95% CI (0.98-1.12), P=0.151]. No significant associations were found for neurological disease mortality [HR=0.96, 95%CI (0.83-1.11), P=0.976] or accident-related mortality [HR=0.91, 95% CI (0.81-1.02), P=0.629]. Sensitivity analysis supports the findings. Subgroup analyses revealed higher all-cause mortality risks in Europe (HR=1.11) and Asia (HR=1.23), as well as an increased risk with greater disease severity (moderate-to-severe: HR=1.44; severe: HR=1.54). No publication bias was detected. Conclusion: Psoriasis is associated with an increased risk of all-cause, cardiovascular, infection-related, and suicide mortality, highlighting the need for enhanced monitoring and targeted interventions to prevent adverse outcomes particularly for individuals with severe psoriasis. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251017192, identifier CRD420251017192.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.033 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.057 |
| Bibliometrics | 0.009 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".