Complications and mortality of Cushing’s disease: report on data collected over a 20-year period at a referral centre
Authors' conclusion
Patients with active CD presented a poor survival outcome. Remission restored the patients' life expectancy regardless of the timing or the types of treatments used to achieve it. Persistent CD-related comorbidities remained major risk factors.
Study context
- Population
- Cushing's disease (CD) patients attending a single referral hospital, 2001–2021; median age at diagnosis 39 years
- Participants
- 126 patients
- Exposure
- Remission vs persistent CD
- Remissionn = 78
- Outcome
- Prevalence of cortisol-related complications and mortality
Methodological detailssingle referral centre, clinical chart review, 2001–2021
- Single referral centre
- Clinical chart review, 2001–2021
Main finding
As reported in the abstract
Standardized mortality ratio (SMR) · last follow-up
| Group | Value | p |
|---|---|---|
| Persistent CD | Standardized mortality ratio (SMR) 4.99 (CI 2.15–9.83) | p < 0.001 |
| Remission | SMR 1.66 (CI 0.34–4.85) | p = 0.543 |
Value
Persistent CDSMR 4.99 (CI 2.15–9.83)
RemissionSMR 1.66 (CI 0.34–4.85)
p
Persistent CDp < 0.001
Remissionp = 0.543
- In remission at last examination
- 78/126 (61.9%)
Observational data: associations, not effects.
Further findings
Cardiovascular (CV) comorbidities
- Significant improvement in all CV comorbidities in patients in remission
- P < 0.05
CV events
- More frequent in older patients
- P = 0.003
- More frequent in smokers and persistent CD
- P < 0.05
Thromboembolic and infective events
- Most occurred during active stages of disease
Factors increasing survival
- Younger age at diagnosis
- P = 0.005
- Microadenoma
- P = 0.002
- Remission at last follow-up
- P = 0.027
- Higher number of comorbidities, in particular arterial hypertension, increased mortality
Original publication
Complications and mortality of Cushing’s disease: report on data collected over a 20-year period at a referral centre. Pituitary. Published 26 July 2023. doi:10.
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