Socioeconomic status and its association with outcome in patients with Cushing's disease
(2025) In European Journal of Endocrinology 192(3). p.159-169- Abstract
Objective: Cushing's disease (CD) is associated with severely impaired quality of life and shortened life expectancy. Little is known about the socioeconomic consequences of CD and their impact on long-term outcome. Methods: This was a nationwide study including 371 patients with CD (76% women), diagnosed between 1991 and 2018, and 4 matched controls per patient from the background population. Clinical data were retrieved from the national Swedish pituitary register and socioeconomic data were collected from national Swedish registers from up to 20 years before and up to 20 years after diagnosis. Results: The proportion of patients receiving disability pensions was increased, starting 6 years before diagnosis, and increased further... (More)
Objective: Cushing's disease (CD) is associated with severely impaired quality of life and shortened life expectancy. Little is known about the socioeconomic consequences of CD and their impact on long-term outcome. Methods: This was a nationwide study including 371 patients with CD (76% women), diagnosed between 1991 and 2018, and 4 matched controls per patient from the background population. Clinical data were retrieved from the national Swedish pituitary register and socioeconomic data were collected from national Swedish registers from up to 20 years before and up to 20 years after diagnosis. Results: The proportion of patients receiving disability pensions was increased, starting 6 years before diagnosis, and increased further thereafter, mainly due to mental and musculoskeletal disorders, to reach around 20%-25% during long-term follow-up. Low educational level in patients with CD was associated with lower rates of employment and increased mortality (adjusted hazard ratio 2.5, 95% CI 1.1-5.4). Conclusions: CD is associated with low socioeconomic status that is already noticeable 6 years before diagnosis and remains high during follow-up. Low socioeconomic status, in particular low educational level, is associated with adverse outcome. The findings indicate a need for proactive rehabilitation plans as part of standard management.
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- author
- Bengtsson, Daniel ; Järås, Jacob ; Burman, Pia LU ; Wahlberg, Jeanette and Ragnarsson, Oskar
- organization
- publishing date
- 2025-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cushing's disease, disability pension, educational level, pituitary adenoma, socioeconomic
- in
- European Journal of Endocrinology
- volume
- 192
- issue
- 3
- pages
- 11 pages
- publisher
- Society of the European Journal of Endocrinology
- external identifiers
-
- pmid:39973315
- scopus:86000673937
- ISSN
- 0804-4643
- DOI
- 10.1093/ejendo/lvaf021
- language
- English
- LU publication?
- yes
- id
- 16066267-1e4a-4c51-8985-b52ea5f921a4
- date added to LUP
- 2025-06-23 10:15:03
- date last changed
- 2025-07-07 10:30:58
@article{16066267-1e4a-4c51-8985-b52ea5f921a4,
abstract = {{<p>Objective: Cushing's disease (CD) is associated with severely impaired quality of life and shortened life expectancy. Little is known about the socioeconomic consequences of CD and their impact on long-term outcome. Methods: This was a nationwide study including 371 patients with CD (76% women), diagnosed between 1991 and 2018, and 4 matched controls per patient from the background population. Clinical data were retrieved from the national Swedish pituitary register and socioeconomic data were collected from national Swedish registers from up to 20 years before and up to 20 years after diagnosis. Results: The proportion of patients receiving disability pensions was increased, starting 6 years before diagnosis, and increased further thereafter, mainly due to mental and musculoskeletal disorders, to reach around 20%-25% during long-term follow-up. Low educational level in patients with CD was associated with lower rates of employment and increased mortality (adjusted hazard ratio 2.5, 95% CI 1.1-5.4). Conclusions: CD is associated with low socioeconomic status that is already noticeable 6 years before diagnosis and remains high during follow-up. Low socioeconomic status, in particular low educational level, is associated with adverse outcome. The findings indicate a need for proactive rehabilitation plans as part of standard management.</p>}},
author = {{Bengtsson, Daniel and Järås, Jacob and Burman, Pia and Wahlberg, Jeanette and Ragnarsson, Oskar}},
issn = {{0804-4643}},
keywords = {{Cushing's disease; disability pension; educational level; pituitary adenoma; socioeconomic}},
language = {{eng}},
number = {{3}},
pages = {{159--169}},
publisher = {{Society of the European Journal of Endocrinology}},
series = {{European Journal of Endocrinology}},
title = {{Socioeconomic status and its association with outcome in patients with Cushing's disease}},
url = {{http://dx.doi.org/10.1093/ejendo/lvaf021}},
doi = {{10.1093/ejendo/lvaf021}},
volume = {{192}},
year = {{2025}},
}