{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:15:06Z","timestamp":1778649306189,"version":"3.51.4"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"5","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>Patients with Cushing\u2019s syndrome (CS) have increased mortality. The aim of this study was to evaluate the causes and time of death in a large cohort of patients with CS and to establish factors associated with increased mortality.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In this cohort study, we analyzed 1564 patients included in the European Registry on CS (ERCUSYN); 1045 (67%) had pituitary-dependent CS, 385 (25%) adrenal-dependent CS, 89 (5%) had an ectopic source and 45 (3%) other causes. The median (IQR) overall follow-up time in ERCUSYN was 2.7 (1.2\u20135.5) years.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Forty-nine patients had died at the time of the analysis; 23 (47%) with pituitary-dependent CS, 6 (12%) with adrenal-dependent CS, 18 (37%) with ectopic CS and two (4%) with CS due to other causes. Of 42 patients whose cause of death was known, 15 (36%) died due to progression of the underlying disease, 13 (31%) due to infections, 7 (17%) due to cardiovascular or cerebrovascular disease and 2 due to pulmonary embolism. The commonest cause of death in patients with pituitary-dependent CS and adrenal-dependent CS were infectious diseases (<jats:italic>n<\/jats:italic>\u2009=\u20098) and progression of the underlying tumor (<jats:italic>n<\/jats:italic>\u2009=\u200910) in patients with ectopic CS. Patients who had died were older and more often males, and had more frequently muscle weakness, diabetes mellitus and ectopic CS, compared to survivors. Of 49 deceased patients, 22 (45%) died within 90 days from start of treatment and 5 (10%) before any treatment was given. The commonest cause of deaths in these 27 patients were infections (<jats:italic>n<\/jats:italic>\u2009=\u200910; 37%). In a regression analysis, age, ectopic CS and active disease were independently associated with overall death before and within 90 days from the start of treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Mortality rate was highest in patients with ectopic CS. Infectious diseases were the commonest cause of death soon after diagnosis, emphasizing the need for careful clinical vigilance at that time, especially in patients presenting with concomitant diabetes mellitus.<\/jats:p>\n<\/jats:sec>","DOI":"10.1530\/eje-19-0464","type":"journal-article","created":{"date-parts":[[2019,9,3]],"date-time":"2019-09-03T15:50:40Z","timestamp":1567525840000},"page":"461-472","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":84,"title":["High mortality within 90 days of diagnosis in patients with Cushing\u2019s syndrome: results from the ERCUSYN registry"],"prefix":"10.1093","volume":"181","author":[{"given":"Elena","family":"Valassi","sequence":"first","affiliation":[{"name":"1IIB-Sant Pau and Department of Endocrinology\/Medicine, Hospital Sant Pau, UAB, and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, Barcelona, Spain"}]},{"given":"Antoine","family":"Tabarin","sequence":"additional","affiliation":[{"name":"2Department of Endocrinology, Diabetes and Nutrition, University of Bordeaux, Bordeaux, France"}]},{"given":"Thierry","family":"Brue","sequence":"additional","affiliation":[{"name":"3Aix-Marseille Universit\u00e9, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale INSERM U1251, Marseille Medical Genetics, Marseille, France and Assistance Publique H\u00f4pitaux de Marseille (APHM), H\u00f4pital de la Conception, Marseille, France"}]},{"given":"Richard A","family":"Feelders","sequence":"additional","affiliation":[{"name":"4Erasmus University Medical Centre, Rotterdam, The Netherlands"}]},{"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"5Medizinische Klinik und Poliklinik IV, Campus Innestadt, Klinikum der Universit\u00e4t M\u00fcnchen, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, Munich, Germany"}]},{"given":"Romana","family":"Netea-Maier","sequence":"additional","affiliation":[{"name":"6Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands"}]},{"given":"Mikl\u00f3s","family":"T\u00f3th","sequence":"additional","affiliation":[{"name":"72nd Department of Medicine, Semmelweis University, Budapest, Hungary"}]},{"given":"Sabina","family":"Zacharieva","sequence":"additional","affiliation":[{"name":"8Medical University of Sofia, Sofia, Bulgary"}]},{"given":"Susan M","family":"Webb","sequence":"additional","affiliation":[{"name":"1IIB-Sant Pau and Department of Endocrinology\/Medicine, Hospital Sant Pau, UAB, and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, Barcelona, Spain"}]},{"given":"Stylianos","family":"Tsagarakis","sequence":"additional","affiliation":[{"name":"9Athens Polyclinic General Hospital & Evangelismos Hospital, Athens, Greece"}]},{"given":"Philippe","family":"Chanson","sequence":"additional","affiliation":[{"name":"10Univ Paris-Sud, Universit\u00e9 Paris-Saclay UMR-S1185, Le Kremlin Bic\u00eatre, Paris, France"},{"name":"11Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital de Bic\u00eatre, Service de Endocrinologie et des Maladies de la Reproduction, Le Kremlin Bic\u00eatre, Paris, France"},{"name":"12Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1185, Le Kremlin Bic\u00eatre, Paris, France"}]},{"given":"Marija","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"13Klinicni Center, Ljubljana, Slovenia"}]},{"given":"Michael","family":"Droste","sequence":"additional","affiliation":[{"name":"14Praxis f\u00fcr Endokrinologie Droste, Oldenburg, Germany"}]},{"given":"Irina","family":"Komerdus","sequence":"additional","affiliation":[{"name":"15Moscow Regional Research Clinical Institute n.a. Vladimirsky, Moscow, Russia"}]},{"given":"Darko","family":"Kastelan","sequence":"additional","affiliation":[{"name":"16Department of Endocrinology, University Hospital Zagreb, Zagreb, Croatia"}]},{"given":"Dominique","family":"Maiter","sequence":"additional","affiliation":[{"name":"17UCL Cliniques Universitaires St Luc, Brussels, Belgium"}]},{"given":"Olivier","family":"Chabre","sequence":"additional","affiliation":[{"name":"18Hospitalier Universitaire, Grenoble, France"}]},{"given":"Holger","family":"Franz","sequence":"additional","affiliation":[{"name":"19Lohmann & Birkner Health Care Consulting GmbH, Berlin, Germany"}]},{"given":"Alicia","family":"Santos","sequence":"additional","affiliation":[{"name":"1IIB-Sant Pau and Department of Endocrinology\/Medicine, Hospital Sant Pau, UAB, and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, Barcelona, Spain"}]},{"given":"Christian J","family":"Strasburger","sequence":"additional","affiliation":[{"name":"20Division of Clinical Endocrinology, Department of Medicine CCM, Charit\u00e9-Universit\u00e4tsmedizin, Berlin, Germany"}]},{"given":"Peter J","family":"Trainer","sequence":"additional","affiliation":[{"name":"21Department of Endocrinology, Christie Hospital, Manchester, UK"}]},{"given":"John","family":"Newell-Price","sequence":"additional","affiliation":[{"name":"22Academic Unit of Diabetes, Endocrinology and Reproduction, Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK"}]},{"given":"Oskar","family":"Ragnarsson","sequence":"additional","affiliation":[{"name":"23Institute of Medicine at Sahlgrenska Academy, University of Gothenburg and the Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[]},{"given":"_","family":"_","sequence":"additional","affiliation":[]},{"given":"A","family":"Ambrogio","sequence":"additional","affiliation":[]},{"given":"G","family":"Aranda","sequence":"additional","affiliation":[]},{"given":"M","family":"Arosio","sequence":"additional","affiliation":[]},{"given":"M","family":"Balomenaki","sequence":"additional","affiliation":[]},{"given":"P","family":"Beck-Peccoz","sequence":"additional","affiliation":[]},{"given":"C","family":"Berr-Kirmair","sequence":"additional","affiliation":[]},{"given":"M.","family":"Bolanowski","sequence":"additional","affiliation":[]},{"given":"J","family":"Bollerslev","sequence":"additional","affiliation":[]},{"given":"Brue","family":"Thierry","sequence":"additional","affiliation":[]},{"given":"D","family":"Carvalho","sequence":"additional","affiliation":[]},{"given":"F","family":"Cavagnini","sequence":"additional","affiliation":[]},{"given":"E","family":"Christ","sequence":"additional","affiliation":[]},{"given":"F","family":"Demtr\u00f6der Zentrum fur Endokrinologi","sequence":"additional","affiliation":[]},{"given":"J","family":"Denes","sequence":"additional","affiliation":[]},{"given":"C","family":"Dimopoulou","sequence":"additional","affiliation":[]},{"given":"A","family":"Dreval","sequence":"additional","affiliation":[]},{"given":"T","family":"Dusek","sequence":"additional","affiliation":[]},{"given":"E","family":"Erdinc","sequence":"additional","affiliation":[]},{"given":"J A","family":"Evang","sequence":"additional","affiliation":[]},{"given":"J","family":"Fazel","sequence":"additional","affiliation":[]},{"given":"S","family":"Fica","sequence":"additional","affiliation":[]},{"given":"E","family":"Ghigo","sequence":"additional","affiliation":[]},{"given":"M","family":"Goth","sequence":"additional","affiliation":[]},{"given":"Y","family":"Greenman","sequence":"additional","affiliation":[]},{"given":"V","family":"Greisa","sequence":"additional","affiliation":[]},{"given":"I","family":"Halperin","sequence":"additional","affiliation":[]},{"given":"FA","family":"Hanzu","sequence":"additional","affiliation":[]},{"given":"A","family":"Hermus","sequence":"additional","affiliation":[]},{"given":"G","family":"Johannsson","sequence":"additional","affiliation":[]},{"given":"P","family":"Kamenicky","sequence":"additional","affiliation":[]},{"given":"A","family":"Kasperlik-Zaluska","sequence":"additional","affiliation":[]},{"given":"J","family":"Kirchner","sequence":"additional","affiliation":[]},{"given":"Kastelan","family":"Darko","sequence":"additional","affiliation":[]},{"given":"I","family":"Kraljevic","sequence":"additional","affiliation":[]},{"given":"A","family":"Kruszynska","sequence":"additional","affiliation":[]},{"given":"I","family":"Lambrescu","sequence":"additional","affiliation":[]},{"given":"S","family":"Lang","sequence":"additional","affiliation":[]},{"given":"A","family":"Luger","sequence":"additional","affiliation":[]},{"given":"N","family":"Marpole","sequence":"additional","affiliation":[]},{"given":"S","family":"Martin","sequence":"additional","affiliation":[]},{"given":"M","family":"Martinie","sequence":"additional","affiliation":[]},{"given":"O","family":"Moros","sequence":"additional","affiliation":[]},{"given":"J","family":"Newell-Price","sequence":"additional","affiliation":[]},{"given":"M","family":"Orbetzova","sequence":"additional","affiliation":[]},{"given":"I","family":"Paiva","sequence":"additional","affiliation":[]},{"given":"F","family":"Pecori Giraldi","sequence":"additional","affiliation":[]},{"given":"AM","family":"Pereira","sequence":"additional","affiliation":[]},{"given":"J","family":"Pickel","sequence":"additional","affiliation":[]},{"given":"V","family":"Pirags","sequence":"additional","affiliation":[]},{"given":"O","family":"Ragnarsson","sequence":"additional","affiliation":[]},{"given":"AD","family":"Reghina","sequence":"additional","affiliation":[]},{"given":"P","family":"Riesgo","sequence":"additional","affiliation":[]},{"given":"M","family":"Roberts","sequence":"additional","affiliation":[]},{"given":"S","family":"Roerink","sequence":"additional","affiliation":[]},{"given":"O","family":"Roig","sequence":"additional","affiliation":[]},{"given":"C","family":"Rowan","sequence":"additional","affiliation":[]},{"given":"P","family":"Rudenko","sequence":"additional","affiliation":[]},{"given":"MA","family":"Sahnoun","sequence":"additional","affiliation":[]},{"given":"J","family":"Salvador","sequence":"additional","affiliation":[]},{"given":"HA","family":"Sigurjonsdottir","sequence":"additional","affiliation":[]},{"given":"T","family":"Skoric Polovina","sequence":"additional","affiliation":[]},{"given":"R","family":"Smith","sequence":"additional","affiliation":[]},{"given":"B","family":"Stachowska","sequence":"additional","affiliation":[]},{"given":"G","family":"Stalla","sequence":"additional","affiliation":[]},{"given":"J","family":"T\u0151ke","sequence":"additional","affiliation":[]},{"given":"E","family":"Ubina","sequence":"additional","affiliation":[]},{"given":"S","family":"Vinay","sequence":"additional","affiliation":[]},{"given":"M","family":"Wagenmakers","sequence":"additional","affiliation":[]},{"given":"S","family":"Werner","sequence":"additional","affiliation":[]},{"given":"J","family":"Young","sequence":"additional","affiliation":[]},{"given":"P","family":"Zdunowski","sequence":"additional","affiliation":[]},{"given":"K","family":"Zopf","sequence":"additional","affiliation":[]},{"given":"S","family":"Zopp","sequence":"additional","affiliation":[]},{"given":"I","family":"Zosin","sequence":"additional","affiliation":[]}],"member":"286","container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/181\/5\/EJE-19-0464.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/181\/5\/EJE-19-0464.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:13:39Z","timestamp":1676391219000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/181\/5\/461\/6654077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":0,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.1530\/eje-19-0464","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}