Assessment of Mortality among Inpatient Cases with Severe Dermatologic Diseases: Infection and Sepsis, the Most Common cause of Mortality

Background: Dermatologic diseases are generally managed at an outpatient clinic and most cases have very low mortality rates. However, some dermatologic diseases are life-threatening and only a few studies have assessed their mortality rates and associated factors. Objective: To investigate the mortality of inpatients with dermatological diseases. Methods: This retrospective study was conducted by reviewing the medical records of patients who died in the dermatology ward at a tertiary hospital in Korea in a period of 17 years. Patient demographics, dermatologic diseases, immediate cause of death, comorbidities, and clinical factors related with mortality were investigated. Results: The total number of inpatients in the dermatology ward during the study period was 740. Thirteen patients (1.76%, 5 men and 8 women) expired while they were admitted in the hospital. The median age of the patients was 63.8 years (range, 18 to 86), and the maximum number of deaths occurred in patients over 70 years old (7 out of 13 patients, 53.8%). Drug reactions were the most common dermatologic complication resulting in admission, followed by bullous disease, generalized pustular psoriasis, and dermatomyositis. Most patients had multiple comorbidities, including hypertension, diabetes mellitus, kidney disease, and angina. Sepsis due to infection was the most common cause of death. Conclusion: Infection was the most important factor contributing to mortality. Old age, immunosuppression, and comorbidities were important factors that contributed to mortality in dermatologic inpatients.