A cohort study linked increased mortality in patients treated surgically for Dupuytren's contracture.
OBJECTIVE
Dupuytren's contracture (DC) is a fibromatous disease of the palmar fascia of unknown etiology. The objective of this study was to assess whether individuals treated for DC exhibited an altered standardized mortality ratio.


METHODS
A total of 16,517 patients operated on for DC between 1965 and 1995 were identified by the Swedish Inpatient Register. For the 7,579 patients who had died during that period, cause of death was obtained from the Swedish Death Register.


RESULTS
There was an overall increased mortality (standardized mortality ratio [SMR]=1.06), inversely related to age and significant for both sexes, in patients under 70 years of age. The risk estimate was highest for endocrine diseases (highest value in patients 40-49 years of age at surgery; SMR=2.82), gastrointestinal diseases (highest value in those 40-49 years of age at surgery; SMR=2.69), accidents (highest value in those 30-39 years of age at surgery; SMR=2.40), and respiratory diseases (highest value in those 50-59 years of age at surgery; SMR=1.61). There was also an increased SMR for cardiovascular diseases in patients 40-59 years of age more than 10 years after surgery (highest value in those 40-49 years of age at surgery; SMR=1.65).


CONCLUSIONS
The most probable mechanism for the increased mortality is related to smoking and other lifestyle factors.
Wilbrand
Stephan
S
Department of Hand Surgery, University Hospital, Uppsala, Sweden. Stephan.Wilbrand@surgsci.uu.se
Ekbom
Anders
A
Gerdin
Bengt
B
D000059:Accidents / Q000401:mortality; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D003644:Death Certificates; D004387:Dupuytren Contracture / Q000401:mortality* / Q000601:surgery*; D004700:Endocrine System Diseases / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000401:mortality; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology