Mortality in Cushing's syndrome: declining over 2 decades but remaining higher than the general population
Main finding · All-cause mortalityResult — go to the resultHazard ratio 1.44 95% CI 1.19–1.75Authors' conclusion
This is the largest national cohort study on mortality risk in CS over the past 2 decades, showing a significantly higher risk compared to matched controls in a homogeneous database. While etiology had no impact, remission significantly affected mortality, highlighting the importance of disease control for long-term survival.
Study context
- Population
- Patients with endogenous Cushing's syndrome (CS), Clalit Health Services database, Israel, 2000–2023; cases mean age 48.1 ± 17.2 years, 65.0% womenmatched cohort
- Participants
- 609 vs 3,018
- Exposure
- Endogenous CS vs matched controls
- CSn = 609
- Controlsn = 3,018reference
- Outcome
- All-cause mortality
- Follow-up
- Median 16 years
Methodological detailsnationwide, matched 1:5 by age, sex, socioeconomic status and body mass index (BMI)
- Nationwide
- Matched 1:5 by age, sex, socioeconomic status and BMI
Main finding
As reported in the abstract
Hazard ratio
1.44
95% CI 1.19–1.75
Events by group
CSvs Controls
HR 1.44 (95% CI 1.19–1.75)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR for death (95% CI) | |
|---|---|---|
| Mortality by disease source: CDvs matched controls · median follow-up 16 years | 1.73 (1.27–2.36) | |
| Mortality by remission status: no remission within 2 yearsvs remissionHigher mortality risk without remission | 1.44 (1.00–2.17) | |
| Mortality by disease source: adrenal CSvs matched controls · median follow-up 16 years | 1.31 (1.00–1.81) | |
| Mortality, CDvs adrenal CSMortality similar | .83 (.56-1.24) | |
| 0.512HR for death (log scale) |
Mortality risk factors
- Older age, male gender and prior malignancy were independent risk factors for mortality
Original publication
Mortality in Cushing's syndrome: declining over 2 decades but remaining higher than the general population. Eur J Endocrinol. Published 2 April 2025. doi:10.
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