ECE2014 Poster Presentations Pituitary Clinical (<emphasis role="italic">Generously supported by IPSEN</emphasis>) (108 abstracts)
Determinants of survival in treated patients with acromegaly
Simona Galoiu 1, , Andreea Suvoiala 2 , Aurelia Luca 2 , Sorin Ioacara 1, , Mariana Purice 2 , Ionela Baciu 1, , Raluca Trifanescu 1, , Mihail Coculescu 1, & Catalina Poiana 1,
1‘Carol Davila’ University of Meidicne and Pharmacy, Bucharest, Romania; 2‘C.I.Parhon’ National Institute of Endocrinology, Bucharest, Romania; 3‘Elias’ Emergency University Hospital, Bucharest, Romania.
Introduction: Patients with untreated acromegaly have a reduced survival, mostly due to vascular disease. Recent studies claim an improvement of survival in the last years.
Aims: To assess mortality ratio and to identify prognostic factors associated with reduced survival in acromegaly.
Methods: Three hundred and twenty-seven patients (207 F/110 M, mean age 48.1±0.7 years, (range 18–81.42)) with acromegaly admitted in a single Neuroendocrinology Department between January 2001 and December 2012 were retrospectively studied by GH, IGF1 levels at diagnosis and posttreatment, therapy, pituitary failure, date and cause of death. PAMCOMP computation program was used to calculate standardized mortality ratio (SMR). Cox regression analysis revealed independent factors associated with mortality. Serum GH levels were measured by IRMA (sensitivity 0.1 ng/ml).
Results: Crude death rate was 11.2 deaths/1000 person years, with an average follow-up of 1963.2 person years (median −5.9 years). All causes mortality rate was not statistically different from that of general population: SMR was 1.06 (95% CI 0.69–1.7).
Survivors were more frequently treated by pituitary surgery (202/305 patients), and/or somatostatin analogues (125/305 patients) than deceased patients (8/22 received operation, P=0.04 and 2/22 received somatostatin analogues, P=0.04). Posttreatment GH levels (hazard ratio (HR) 1.06, 95%CI 1.03–1.09), acromegaly duration (HR 1.08, 95%CI 1.02–1.1) and age at diagnosis (HR 1.06, 95% CI 1.02–1.1) were independent predictors of mortality. Posttreatment GH levels above 5.5 ng/ml was associated with an increased mortality: SMR=1.7 (95%CI 1.003–2.853).
Conclusions: Patients with acromegaly admitted in the last 12 years had a mortality rate similar with general population, mainly due to modern therapy. Posttreatment serum GH levels and acromegaly duration were the main predictors of survival.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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