Mortality in a cohort of Danish patients with fibromyalgia – increased suicide, liver disease and cerebrovascular disease – Source: Arthritis and Rheumatism, Jun 25, 2020

Objective: A previous study demonstrated association of self-reported widespread body pain with increased mortality. Our aim was to analyse whether fibromyalgia (FM) and FM-like symptoms are related to an increased mortality.

Methods:
We identified from hospital records 1,361 patients referred on suspicion of FM during the period 1984-1999. Cases were reviewed blinded to outcome. The cohort was followed for a total of 5,295 person-years at risk and linked to the Danish Mortality Register.

Using the number of years at risk and sex-, age- and calendar-specific mortality rates from the general population, cause-specific Standardized Mortality Ratios [SMRs] were calculated.

Results:

• We found no overall increased rate of mortality in FM.

• Among the 1,269 female patients, an increased risk of death from suicide SMR=10.5 [95%CI: 4.5-20.7], liver cirrhosis/biliary tract disease SMR=6.4 [95%CI:2.3-13.9], and cerebrovascular disease SMR=3.1 [95%CI:1.1-6.8] was observed. Suicide risk was increased at time of diagnosis and remained after 5 years.

• Patients meeting the American College of Rheumatology criteria for FM and patients with possible FM had the same cause-specific mortality pattern.

• No increased cause-specific mortality was observed in the 84 male patients.

Conclusion:
The causes of markedly increased rate of suicide in female FM are at present unknown, but may be related to increased rates of lifetime depression, anxiety, and psychiatric disorders. Risk factors for suicide should be sought at time of diagnosis and at follow up.

The results also suggest that risk factors for liver disease and cerebrovascular disease should be evaluated in FM patients.

Source: Arthritis and Rheumatism, Jun 25, 2020. PMID: 20583101 by Dreyer L, Kendall S, Danneskiold-Samsøe B, Bartels EM, Bliddal H. Department of Rheumatology, Copenhagen University Hospital, Rigshospitalet, Denmark.

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