+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Decreasing mortality and changes in treatment patterns in patients with acromegaly from a nationwide study



Decreasing mortality and changes in treatment patterns in patients with acromegaly from a nationwide study



European Journal of Endocrinology 178(5): 459-469



New therapeutic strategies have developed for the management of acromegaly over recent decades. Whether this has improved mortality has not been fully elucidated. The primary aim was to investigate mortality in a nationwide unselected cohort of patients with acromegaly. Secondary analyses included time trends in mortality and treatment patterns. A total of 1089 patients with acromegaly were identified in Swedish National Health Registries between 1987 and 2013. To analyse time trends, the cohort was divided into three periods (1987-1995, 1996-2004 and 2005-2013) based on the year of diagnosis. Using the Swedish population as reference, standardized mortality ratios (SMRs) were calculated with 95% confidence intervals (CIs). Overall SMR was 2.79 (95% CI: 2.43-3.15) with 232 observed and 83 expected deaths. Mortality was mainly related to circulatory diseases (SMR: 2.95, 95% CI: 2.35-3.55), including ischemic heart disease (2.00, 1.35-2.66) and cerebrovascular disease (3.99, 2.42-5.55) and malignancy (1.76, 1.27-2.26). Mortality decreased over time, with an SMR of 3.45 (2.87-4.02) and 1.86 (1.04-2.67) during the first and last time period, respectively (P = .015). During the same time periods, the frequency of pituitary surgery increased from 58% to 72% (P < 0.001) and the prevalence of hypopituitarism decreased from 41% to 23% (P < 0.001). Excess mortality was found in this nationwide cohort of patients with acromegaly, mainly related to circulatory and malignant diseases. Although still high, mortality significantly declined over time. This could be explained by the more frequent use of pituitary surgery, decreased prevalence of hypopituitarism and the availability of new medical treatment options.

(PDF emailed within 0-6 h: $19.90)

Accession: 057653680

Download citation: RISBibTeXText

PMID: 29483205

DOI: 10.1530/EJE-18-0015


Related references

Decreasing mortality from acute biliary diseases that require endoscopic retrograde cholangiopancreatography: a nationwide cohort study. Clinical Gastroenterology and Hepatology 12(7): 1151-1159.E6, 2015

A nationwide survey of mortality in acromegaly. Journal of Clinical Endocrinology and Metabolism 90(7): 4081-4086, 2005

Treatment results in 235 patients with acromegaly a report of the acromegaly study group. Acta Endocrinologica Supplementum 96(240): 66-67, 1981

Mortality in the treatment of obstructive jaundice patients and measures for decreasing mortality. Klinicheskaia Khirurgiia 1987(9): 12-14, 1987

Metformin treatment is associated with a low risk of mortality in diabetic patients with heart failure: a retrospective nationwide cohort study. Diabetologia 53(12): 2546-2553, 2011

Type of preadmission antidiabetic treatment and mortality among patients hospitalized with myocardial infarction: a nationwide follow-up study. 2007

Decreasing mortality and changing patterns of causes of death in the Swiss HIV Cohort Study. HIV Medicine 14(4): 195-207, 2013

Mortality and cancer incidence in acromegaly: a retrospective cohort study. United Kingdom Acromegaly Study Group. Journal of Clinical Endocrinology and Metabolism 83(8): 2730-2734, 1998

Real-world treatment patterns for patients 80 years and older with early lung cancer: a nationwide claims study. Bmc Pulmonary Medicine 18(1): 127, 2018

Treatment outcomes and mortality of 94 patients with acromegaly. Acta Neurochirurgica 147(3): 243-51; Discussion 250-1, 2005

Change in child mortality patterns after injuries in Sweden: a nationwide 14-year study. European Journal of Trauma and Emergency Surgery 43(3): 343-349, 2016

Restarting Anticoagulant Treatment After Intracranial Hemorrhage in Patients With Atrial Fibrillation and the Impact on Recurrent Stroke, Mortality, and Bleeding: A Nationwide Cohort Study. Circulation 132(6): 517-525, 2015

Changes in mortality patterns following total hip or knee arthroplasty over the past two decades: a nationwide cohort study. Arthritis and Rheumatology 66(2): 311-318, 2014

Patterns of pharmacologic treatment in US patients with acromegaly. Current Medical Research and Opinion 32(5): 799-805, 2017

Interferon-Based Treatment of Hepatitis C Virus Infection Reduces All-Cause Mortality in Patients With End-Stage Renal Disease: An 8-Year Nationwide Cohort Study in Taiwan. Medicine 94(47): E2113, 2016