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Sökning: onr:"swepub:oai:DiVA.org:liu-158812" > Overall and Disease...

Overall and Disease-Specific Mortality in Patients With Cushing Disease: A Swedish Nationwide Study

Ragnarsson, Oskar, (författare)
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
Olsson, Daniel S., (författare)
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
Papakokkinou, Eleni, (författare)
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
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Chantzichristos, Dimitrios, (författare)
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
Dahlqvist, Per, (författare)
Umea Univ, Sweden
Segerstedt, Elin, (författare)
Umea Univ, Sweden
Olsson, Tommy, (författare)
Umea Univ, Sweden
Petersson, Maria, (författare)
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
Berinder, Katarina, (författare)
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
Bensing, Sophie, (författare)
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
Hoybye, Charlotte, (författare)
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
Eden-Engstrom, Britt, (författare)
Uppsala Univ Hosp, Sweden
Burman, Pia, (författare)
Lund Univ, Sweden
Bonelli, Lorenza, (författare)
Lund Univ, Sweden
Follin, Cecilia, (författare)
Skane Univ Hosp, Sweden
Petranek, David, (författare)
Skane Univ Hosp, Sweden
Erfurth, Eva Marie, (författare)
Skane Univ Hosp, Sweden
Wahlberg, Jeanette, (författare)
Linköpings universitet, Avdelningen för kardiovaskulär medicin, Linköpings universitet, Medicinska fakulteten, Region Östergötland, Endokrinmedicinska kliniken
Ekman, Bertil, (författare)
Linköpings universitet, Avdelningen för kardiovaskulär medicin, Linköpings universitet, Medicinska fakulteten, Region Östergötland, Endokrinmedicinska kliniken
Akerman, Anna-Karin, (författare)
Orebro Univ, Sweden
Schwarcz, Erik, (författare)
Orebro Univ, Sweden
Bryngelsson, Ing-Liss, (författare)
Orebro Univ Hosp, Sweden
Johannsson, Gudmundur, (författare)
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
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2019
Engelska.
Ingår i: Journal of Clinical Endocrinology and Metabolism. - ENDOCRINE SOC. - 0021-972X .- 1945-7197. ; 104:6, s. 2375-2384
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • <p>Context: Whether patients with Cushing disease (CD) in remission have increased mortality is still debatable. Objective: To study overall and disease-specific mortality and predictive factors in an unselected nationwide cohort of patients with CD. Design, Patients, and Methods: A retrospective study of patients diagnosed with CD, identified in the Swedish National Patient Registry between 1987 and 2013. Medical records were systematically reviewed to verify the diagnosis. Standardized mortality ratios (SMRs) with 95% CIs were calculated and Cox regression models were used to identify predictors of mortality. Results: Of 502 identified patients with CD (n = 387 women; 77%), 419 (83%) were confirmed to be in remission. Mean age at diagnosis was 43 (SD, 16) years and median follow-up was 13 (interquartile range, 6 to 23) years. The observed number of deaths was 133 vs 54 expected, resulting in an overall SMR of 2.5 (95% CI, 2.1 to 2.9). The commonest cause of death was cardiovascular diseases (SMR, 3.3; 95% CI, 2.6 to 4.3). Excess mortality was also found associated with infections and suicide. For patients in remission, the SMR was 1.9 (95% CI, 1.5 to 2.3); bilateral adrenalectomy and glucocorticoid replacement therapy were independently associated with increased mortality, whereas GH replacement was associated with improved outcome. Conclusion: Findings from this large nationwide study indicate that patients with CD have excess mortality. The findings illustrate the importance of achieving remission and continued active surveillance, along with adequate hormone replacement and evaluation of cardiovascular risk and mental health.</p>

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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