Endocrine Abstracts

Introduction: Patients with non-functioning pituitary adenomas (NFPA) and hipopituitarism had a reduced life expectancy.

Aims: To assess mortality ratio and to identify prognostic factors associated with mortality in patients with NFPA in the last decade.

Methods: A 196 patients (83 F/113 M, mean age 52.7±0.9 years) with NFPA admitted in a single Neuroendocrinology Department between January 2001 and December 2010 were retrospectively studied. PAMCOMP computation program was used to calculate standardized mortality ratio (SMR). Cox regression analysis revealed independent factors associated with mortality.

Results: During follow-up (median 7.5 years–1298.04 person years), 26 patients died, corresponding to a death rate of 20 deaths/1000 person years. Statistically significant more patients with hypopituitarism for at least one axis deceased (22/156, 14.10%), as compared with patients without pituitary failure (1/22 patient deceased – 2.07%), P=0.03. All causes mortality was not statistically different from that of general population: Standardized mortality ratio (SMR) was 1.2 (95% confidence interval (CI) 0.83–1.86). Females had a doubled mortality ratio: SMR 2.03 (95% CI 1.01–3.64), but males had a mortality ratio similar to general population: SMR 0.87 (95% CI 0.48–1.44). When assessed by Cox-regression analysis, prednisone dose for corticotrophin insufficiency (HR 1.5 (95%CI 1.18–1.98)) and last systolic blood pressure (HR 1.04 (95%CI 1.005–1.081)) were independent predictors of mortality in females. Mortality rose progressively with prednisone dose (log rank: P=0.007) in females, but not in males (log rank: P=0.197).

Conclusions: Females with non-functioning pituitary adenomas and hypopituitarism had a doubled mortality ratio as compared with general population, influenced by prednisone dose used for substitution and systolic blood pressure.