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Excess morbidity and mortality in patients with craniopharyngioma: a hospital-based retrospective cohort study.

Artikel i vetenskaplig tidskrift
Författare Mark Wijnen
Daniel S Olsson
Marry M van den Heuvel-Eibrink
Casper Hammarstrand
Joseph A M J L Janssen
Aart J van der Lely
Gudmundur Johannsson
Sebastian J C M M Neggers
Publicerad i European journal of endocrinology
Volym 178
Nummer/häfte 1
Sidor 95-104
ISSN 1479-683X
Publiceringsår 2018
Publicerad vid Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 95-104
Språk en
Länkar dx.doi.org/10.1530/EJE-17-0707
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adolescent, Adult, Age of Onset, Cerebral Infarction, complications, epidemiology, Child, Cohort Studies, Craniopharyngioma, epidemiology, mortality, Diabetes Mellitus, Type 2, complications, epidemiology, Female, Hospital Mortality, Humans, Hydrocephalus, complications, epidemiology, mortality, Incidence, Male, Middle Aged, Morbidity, Netherlands, epidemiology, Pituitary Neoplasms, epidemiology, mortality, Retrospective Studies, Risk Factors, Sex Factors, Sweden, epidemiology, Young Adult
Ämneskategorier Neurokirurgi, Endokrinologi

Sammanfattning

Most studies in patients with craniopharyngioma did not investigate morbidity and mortality relative to the general population nor evaluated risk factors for excess morbidity and mortality. Therefore, the objective of this study was to examine excess morbidity and mortality, as well as their determinants in patients with craniopharyngioma.Hospital-based retrospective cohort study conducted between 1987 and 2014.We included 144 Dutch and 80 Swedish patients with craniopharyngioma identified by a computer-based search in the medical records (105 females (47%), 112 patients with childhood-onset craniopharyngioma (50%), 3153 person-years of follow-up). Excess morbidity and mortality were analysed using standardized incidence and mortality ratios (SIRs and SMRs). Risk factors were evaluated univariably by comparing SIRs and SMRs between non-overlapping subgroups.Patients with craniopharyngioma experienced excess morbidity due to type 2 diabetes mellitus (T2DM) (SIR: 4.4, 95% confidence interval (CI): 2.8-6.8) and cerebral infarction (SIR: 4.9, 95% CI: 3.1-8.0) compared to the general population. Risks for malignant neoplasms, myocardial infarctions and fractures were not increased. Patients with craniopharyngioma also had excessive total mortality (SMR: 2.7, 95% CI: 2.0-3.8), and mortality due to circulatory (SMR: 2.3, 95% CI: 1.1-4.5) and respiratory (SMR: 6.0, 95% CI: 2.5-14.5) diseases. Female sex, childhood-onset craniopharyngioma, hydrocephalus and tumour recurrence were identified as risk factors for excess T2DM, cerebral infarction and total mortality.Patients with craniopharyngioma are at an increased risk for T2DM, cerebral infarction, total mortality and mortality due to circulatory and respiratory diseases. Female sex, childhood-onset craniopharyngioma, hydrocephalus and tumour recurrence are important risk factors.

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