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Premature mortality in patients with Addison's disease: a population-based study
Ragnhildur Bergthorsdottir1, Maria Leonsson-Zachrisson, Anders Odén
1Department of Endocrinology, gr str 8, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. Ragnhildur.Bergthorsdottir@medic.gu.se
The Journal of Clinical Endocrinology and Metabolism
|September 14, 2006
Summary
Patients with Addison's disease have a more than twofold higher risk of death compared to the general population. Cardiovascular, malignant, and infectious diseases contribute significantly to this increased mortality in Addison's disease patients.
Area of Science:
- Endocrinology
- Epidemiology
- Public Health
Background:
- Survival rates for primary adrenal insufficiency (Addison's disease) patients on replacement therapy are not well-established.
- Previous assumptions suggested normal survival rates for well-informed patients.
- This study investigates mortality patterns in Addison's disease patients in Sweden.
Purpose of the Study:
- To evaluate the mortality risk in patients diagnosed with primary adrenal insufficiency.
- To compare the mortality rates of Addison's disease patients with the general Swedish population.
- To identify causes of excess mortality in this patient group.
Main Methods:
- A population-based, retrospective observational study design was employed.
- Data were sourced from the National Swedish Hospital and Cause of Death Registers (1987-2001).
- Individual patient follow-up was conducted from diagnosis to study end or death, with mortality compared to background population rates.
Main Results:
- 1675 patients with primary adrenal insufficiency (995 women, 680 men) were identified.
- The overall risk ratio for all-cause mortality was significantly elevated: 2.19 for men and 2.86 for women.
- Excess mortality was primarily linked to cardiovascular, malignant, and infectious diseases, with diabetes mellitus having a minor contribution.
Conclusions:
- Patients with Addison's disease face a more than twofold higher risk of death compared to the general population.
- Cardiovascular, malignant, and infectious diseases are the primary drivers of increased mortality.
- These findings highlight the need for vigilant monitoring and management of comorbidities in Addison's disease.
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