Mortality in acromegaly: a 20-year follow-up study

Objective It is unclear whether mortality still is increased in acromegaly and whether there are gender-related differences. We dynamically assessed outcome during long-term follow-up in our nationwide cohort. Patients and methods We studied standardized mortality ratios (SMRs) relative to the general population and causes of death in acromegaly (n=333) compared with age- and gender-matched controls (n=4995). Results During 20 (0–33) years follow-up, 113 (34%) patients (n=333, 52% women) and 1334 (27%) controls (n=4995) died (P=0.004). SMR (1.9, 95% CI: 1.53–2.34, P<0.001) and all-cause mortality (OR 1.6, 95% CI: 1.2–2.2, P<0.001) were increased in acromegaly. Overall distribution of causes of death (P<0.001) differed between patients and controls but not cardiovascular (34% vs 33%) or cancer deaths (27% vs 27%). In acromegaly, but not in controls, causes of deaths shifted from 44% cardiovascular and 28% cancer deaths during the first decade, to 23% cardiovascular and 35% cancer deaths during the next two decades. In acromegaly, cancer deaths were mostly attributed to pancreatic adenocarcinoma (n=5), breast (n=4), lung (n=3) and colon (n=3) carcinoma. In acromegaly, men were younger than women at diagnosis (median 44.5 vs 50 years, P<0.001) and death (67 vs 76 years, P=0.0015). Compared with controls, women (36% vs 25%, P<0.01), but not men (31% vs 28%, P=0.44), had increased mortality. Conclusions In acromegaly, men are younger at diagnosis and death than women. Compared with controls, mortality is increased during 20 years of follow-up, especially in women. Causes of deaths shift from predominantly cardiovascular to cancer deaths.

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Causes of Death in Patients with Peptic Ulcer Perforation: A Long-Term Follow-up Study

Scandinavian Journal of Gastroenterology ◽

10.1080/00365529950172772 ◽

1999 ◽

Vol 34 (1) ◽

pp. 18-24 ◽

Cited By ~ 10

Author(s):

C. Svanes, S. A. Lie, R. T. Lie, O.

Keyword(s):

Peptic Ulcer ◽

Causes Of Death ◽

Peptic Ulcer Perforation ◽

Ulcer Perforation ◽

Follow Up Study ◽

Long Term Follow Up

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A long-term follow-up study of Japanese diabetic patients: Mortality and causes of death

Diabetologia ◽

10.1007/bf00253191 ◽

1983 ◽

Vol 25 (4) ◽

Cited By ~ 28

Author(s):

A. Sasaki ◽

M. Uehara ◽

N. Horiuchi ◽

K. Hasagawa

Keyword(s):

Causes Of Death ◽

Diabetic Patients ◽

Follow Up Study ◽

Long Term Follow Up

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Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure

Journal of Telemedicine and Telecare ◽

10.1177/1357633x18774632 ◽

2018 ◽

Vol 25 (5) ◽

pp. 286-293 ◽

Cited By ~ 6

Author(s):

Ines Frederix ◽

Lien Vanderlinden ◽

Anne-Sophie Verboven ◽

Maria Welten ◽

Donna Wouters ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Healthcare Costs ◽

Follow Up Study ◽

All Cause Mortality ◽

Long Term Follow Up ◽

Heart Failure Readmissions ◽

Time Point

Aims The TElemonitoring in the MAnagement of Heart Failure (TEMA-HF) 1 long-term follow-up study assessed whether an initial six-month telemonitoring (TM) programme compared with usual care (UC) would result in reduced all-cause mortality, heart failure admissions and healthcare costs in chronic heart failure (CHF) patients at long-term follow-up. Methods Of the 160 patients included in the multi-centre, randomised controlled telemonitoring trial (TEMA-HF 1, time point t0); 142 CHF patients (65% male; age: 76 ± 10 years; EF: 36 ± 15%) were alive and entered the follow-up study (time point: t1) with a final evaluation at 79 months (time point: t2). Both TM and UC group patients received standard heart failure care during the follow-up study (time points: t1 – t2). The primary endpoint was all-cause mortality. Secondary outcomes included days lost due to heart failure readmissions and readmission/patient follow-up related healthcare costs. Results Compared with usual care, the initial six-month TM programme had no significant effect on all-cause mortality (hazard ratio: 0.83; 95% confidence interval, 0.57 to 1.20; p = 0.32). The number of days lost due to heart failure readmissions was significantly lower in the TM group ( p = 0.04). Healthcare costs did not differ significantly between the TM (€ 9140 ± 10580) and UC group (€ 12495 ± 22433) ( p = 0.87). Discussion An initial six-month telemonitoring programme was not associated with reduced all-cause mortality in CHF patients at long-term follow-up but resulted in a reduction in the number of days lost due to heart failure readmissions. This study is registered in the ClinicalTrials.gov registry (NCT03171038) (URL: https://clinicaltrials.gov/ct2/show/NCT03171038 ).

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Causes of long-term mortality in patients with head and neck squamous cell carcinomas

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-07211-8 ◽

2021 ◽

Author(s):

Joan Lop ◽

María del Prado Venegas ◽

Albert Pujol ◽

Blanca Sauter ◽

Rosselin Vásquez ◽

...

Keyword(s):

Head And Neck ◽

Squamous Cell ◽

Causes Of Death ◽

Second Malignancies ◽

Age And Gender ◽

Competing Causes ◽

And Gender ◽

Long Term Mortality

Abstract Purpose After treatment of a head and neck squamous cell carcinoma (HNSCC), patients with an adequate control of the tumor have a decreased overall survival when compared to age- and gender-matched controls in the general population. The aim of our study was to analyze the causes of long-term mortality in patients with HNSCC. Methods We carried out a retrospective study of 5122 patients with an index HNSCC treated at our center between 1985 and 2018. We analyzed the survival considering three causes of death: mortality associated with the HNSCC index tumor, mortality associated with a second or successive neoplasm, and mortality associated with a non-cancer cause. Results After the diagnosis of an HNSCC the most frequent cause of death is the head and neck tumor itself during the first 3.5 years of follow-up. Thereafter, mortality is more frequently associated with competing causes of death, such as second malignancies and non-cancer causes. Mortality associated with second and successive neoplasms was 2.3% per year, a percentage that was maintained constant throughout the follow-up. Likewise, mortality attributable to non-cancer causes was 1.6% per year, which also remained constant. There were differences in the mortality patterns according to the characteristics of the patients. Conclusion There are differences in the mortality patterns of patients with HNSCC depending on their characteristics. Knowledge of these patterns can help in the design of guidelines to improve the follow-up protocols of this group of patients to optimize the clinical cost-effectiveness.

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