Socioeconomic status and its association with outcome in patients with Cushing's disease
Authors' conclusion
CD is associated with low socioeconomic status that is already noticeable 6 years before diagnosis and remains high during follow-up. Low socioeconomic status, in particular low educational level, is associated with adverse outcome. The findings indicate a need for proactive rehabilitation plans as part of standard management.
Study context
- Population
- Patients with cushing's disease (CD) (76% women) diagnosed 1991–2018, national Swedish pituitary register; socioeconomic data from up to 20 years before to 20 years after diagnosispatients with CD
- Participants
- 371 patients
- Exposure
- Patients with CD vs matched controls from the background population
- CDn = 371
- Outcome
- Disability pension
- Follow-up
- From 6 years before diagnosis to long-term
Methodological details4 matched controls per patient, register-based
- 4 matched controls per patient
- Register-based
Main finding
As reported in the abstract
Proportion of CD patients receiving disability pensions increased, starting 6 years before diagnosis, and increased further thereafter, mainly due to mental and musculoskeletal disorders
around 20%-25% during long-term follow-up
Observational data: associations, not effects.
Further findings
Mortality by low vs higher educational level in CD
| aHR (95% CI) | ||
|---|---|---|
| Low educational levelIncreased mortality with low educational level | 2.5 (1.1–5.4) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- Low educational level in CD associated with lower rates of employment
Original publication
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