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Premature mortality in patients with Addison's disease: a population-based study.

Ragnhildur Bergthorsdottir ; Maria Leonsson-Zachrisson ; Anders Odén (Institutionen för matematiska vetenskaper) ; Gudmundur Johannsson
The Journal of clinical endocrinology and metabolism (0021-972X). Vol. 91 (2006), 12, p. 4849-53.
[Artikel, refereegranskad vetenskaplig]

BACKGROUND: The survival rate of patients with primary adrenal insufficiency (Addison's disease) undergoing currently accepted replacement therapy is not known, although well-informed patients are considered to have a normal survival rate. In this study, we evaluated the mortality of patients with Addison's disease in Sweden. METHODS: A population-based, retrospective, observational study was performed, using the National Swedish Hospital and Cause of Death Registers, covering the period from 1987-2001. After a diagnosis of Addison's disease, each patient was followed until the end of follow-up or death. Mortality was compared with that of the Swedish background population. FINDINGS: We identified 1675 patients (995 women and 680 men) diagnosed with primary adrenal insufficiency. The average follow-up from initial diagnosis was 6.5 yr. Five hundred seven patients died during the study period compared with an expected 199. The risk ratio for all-cause mortality was 2.19 (confidence interval 1.91-2.51) for men and 2.86 (confidence interval 2.54-3.20) for women. The excess mortality in both men and women was attributed to cardiovascular, malignant, and infectious diseases. Concomitant diabetes mellitus was observed in 12% of the patients, but only contributed to the increased mortality to a minor extent. INTERPRETATION: Compared with the background population, we observed that the risk ratio for death was more than 2-fold higher in patients with Addison's disease. Cardiovascular, malignant, and infectious diseases were responsible for the higher mortality rate.

Nyckelord: Addison Disease, mortality, Adult, Cohort Studies, Comorbidity, Diabetes Mellitus, epidemiology, Female, Humans, Male, Middle Aged, Odds Ratio, Sweden, epidemiology



Denna post skapades 2007-10-31. Senast ändrad 2011-01-20.
CPL Pubid: 60297

 

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Institutioner (Chalmers)

Institutionen för medicin, avdelningen för invärtesmedicin (2006-2011)
Institutionen för matematiska vetenskaperInstitutionen för matematiska vetenskaper (GU)

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