The DOI matches its Crossref record; 33 of the 34 references it cites were found in a registry or an index.
Deaths Among Adult Patients With Hypopituitarism: Hypocortisolism During Acute Stress, and De Novo Malignant Brain Tumors Contribute to an Increased Mortality
Open accessAbstract
CONTEXT: Patients with hypopituitarism have an increased standardized mortality rate. The basis for this has not been fully clarified. OBJECTIVE: To investigate in detail the cause of death in a large cohort of patients with hypopituitarism subjected to long-term follow-up. DESIGN AND METHODS: All-cause and cause-specific mortality in 1286 Swedish patients with hypopituitarism prospectively monitored in KIMS (Pfizer International Metabolic Database) 1995-2009 were compared to general population data in the Swedish National Cause of Death Registry. In addition, events reported in KIMS, medical records, and postmortem reports were reviewed. MAIN OUTCOME MEASURES: Standardized mortality ratios (SMR) were calculated, with stratification for gender, attained age, and calendar year during follow-up. RESULTS: An excess mortality was found, 120 deaths vs 84.3 expected, SMR 1.42 (95% confidence interval: 1.18-1.70). Infections, brain cancer, and sudden death were associated with significantly increased SMRs (6.32, 9.40, and 4.10, respectively). Fifteen patients, all ACTH-deficient, died from infections. Eight of these patients were considered to be in a state of adrenal crisis in connection with death (medical reports and post-mortem examinations). Another 8 patients died from de novo malignant brain tumors, 6 of which had had a benign pituitary lesion at baseline. Six of these 8 subjects had received prior radiation therapy. CONCLUSION: Two important causes of excess mortality were identified: first, adrenal crisis in response to acute stress and intercurrent illness; second, increased risk of a late appearance of de novo malignant brain tumors in patients who previously received radiotherapy. Both of these causes may be in part preventable by changes in the management of pituitary disease.
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“Excess cardiovascular mortality might be specifically related to AC (30).”
From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [30]
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Cites
Writing Group for the Women's Health Initiative Investigators (2002) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.288.3.321 · Cited by 15,889
Statistical Methods in Cancer Research
Breslow, N. E. (1980) · Cited by 7,332
Pearce, M. S., Salotti, J. A., Little, M. P., McHugh, K., Lee, C., Kim, K. P., Howe, N. L., Ronckers, C. M., Rajaraman, P., Craft, A. W., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60815-0 · Cited by 3,735
Statistical Methods in Cancer Research. Volume II – The Design and Analysis of Cohort Studies
Juul, S. (1989) · Scandinavian Journal of Social Medicine · doi:10.1177/140349488901700214 · Cited by 3,602
Premature mortality due to cardiovascular disease in hypopituitarism
Rosén, T., & Bengtsson, B.-Å. (1990) · The Lancet · doi:10.1016/0140-6736(90)91812-o · Cited by 1,402
Gebbie, A. E. (2002) · Journal of Family Planning and Reproductive Health Care · doi:10.1783/147118902101196685 · Cited by 1,176
Association between premature mortality and hypopituitarism
Tomlinson, J., Holden, N., Hills, R., Wheatley, K., Clayton, R., Bates, A., Sheppard, M., & Stewart, P. (2001) · The Lancet · doi:10.1016/s0140-6736(00)04006-x · Cited by 1,006
Tumors of the Brain and Nervous System after Radiotherapy in Childhood
Ron, E., Modan, B., Boice, J. D., Alfandary, E., Stovall, M. A., Chetrit, A., & Katz, L. (1988) · New England Journal of Medicine · doi:10.1056/nejm198810203191601 · Cited by 929
Increased cerebrovascular mortality in patients with hypopituitarism
Bülow, B., Hagmar, L., Mikoczy, Z., Nordström, C., & Erfurth, E. M. (1997) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1997.d01-1749.x · Cited by 542
Self-citationMeadows, A. T., Friedman, D. L., Neglia, J. P., Mertens, A. C., Donaldson, S. S., Stovall, M., Hammond, S., Yasui, Y., & Inskip, P. D. (2009) · Journal of Clinical Oncology · doi:10.1200/jco.2008.21.1920 · Cited by 520
Research works printed but not linked: 1
- Breslow, 1987, Analysis of cohort studies, 69
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Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline
Fleseriu, M., Hashim, I. A., Karavitaki, N., Melmed, S., Murad, M. H., Salvatori, R., & Samuels, M. H. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-2118 · Cited by 945
Diagnosis and management of adrenal insufficiency
Bancos, I., Hahner, S., Tomlinson, J., & Arlt, W. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70142-1 · Cited by 467
Hahner, S., Spinnler, C., Fassnacht, M., Burger-Stritt, S., Lang, K., Milovanovic, D., Beuschlein, F., Willenberg, H. S., Quinkler, M., & Allolio, B. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-3191 · Cited by 394
Yuen, K. C. J., Biller, B. M. K., Radovick, S., Carmichael, J. D., Jasim, S., Pantalone, K. M., & Hoffman, A. R. (2019) · Endocrine Practice · doi:10.4158/gl-2019-0405 · Cited by 298
Higham, C., Johannsson, G., & Shalet, S. M. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30053-8 · Cited by 273
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Metadata
- Authors
- Burman, P., Mattsson, A. F., Johannsson, G., Höybye, C., Holmer, H., Dahlqvist, P., Berinder, K., Engström, B. E., Ekman, B., Erfurth, E. M., Svensson, J., Wahlberg, J., & Karlsson, F. A.
- Affiliations
- Skåne University Hospital (SE)
- Pfizer (Sweden) (SE)
- Department of Endocrinology (G.J.), SE-413 45 Gothenburg, Sweden
- Karolinska University Hospital (SE)
- Centralsjukhuset Kristianstad (SE)
- Umeå University (SE)
- Uppsala University (SE)
- Linköping University (SE)
- University of Gothenburg (SE)
- Corresponding author
- Burman, P.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2013-04-01
- Volume
- 98
- Issue
- 4
- Pages
- 1466-1475
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2032579876
- Semantic Scholar
- d11009fa0be3f643281d362bc59272dcf27737b8
- Cited by
- 184
- References
- 34
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 13 · 2023: 13 · 2022: 9 · 2021: 20 · 2020: 16 · 2019: 15 · 2018: 14 · 2017: 23 · 2016: 16 · 2015: 12 · 2014: 20 · 2013: 7
- FWCI
- 14.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- hypopituitarism, mortality, adrenal crisis, adrenal insufficiency, acute stress, pituitary radiotherapy, ACTH deficiency, infection, sudden death, standardized mortality ratio
- MeSH terms
- Acute Disease, Adult, Aged, Astrocytoma, Brain Neoplasms, Cause of Death, Female, Glioma, Humans, Hydrocortisone, Hypopituitarism, Male, Middle Aged, Stress, Psychological, Age of Onset, Young Adult
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