Morbidity and mortality associated with Paget's disease of bone: A population-based study

Robert A. Wermers, Robert D. Tiegs, Elizabeth J. Atkinson, Sara J. Achenbach, L. Joseph Melton

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51 Scopus citations

Abstract

Introduction: Limited information is available about the clinical features of Paget's disease of bone among unselected patients in the community. We examined morbidity and mortality associated with this condition in a large inception cohort of Olmsted County, MN, residents with a new diagnosis of Paget's disease from 1950 through 1994. Materials and Methods: Survival was estimated using the Kaplan-Meier method. Cox proportional hazards models were used to assess the impact of various covariates on death. Results: Paget's disease of bone was diagnosed in 236 Olmsted County residents (mean age at diagnosis, 69.6 yr; 55% men). The majority were symptomatic at diagnosis (58%), and the proportion with symptoms did not change from the prescreening era (1950 to June 1974) to the postscreening era (July 1974-1994). Most patients had polyostotic disease (72%), and the pelvis (67%), vertebra (41%), and femur (31%) were the most common sites of involvement. Skeletal complications attributable to Paget's disease included bowing deformities (7.6%), fracture of pagetic bone (9.7%), and osteosarcoma (0.4%). Osteoarthritis was observed in 73% of patients, and 11% had a hip or knee replacement. Nonskeletal complications related to Paget's disease included cranial nerve (0.4%), peripheral nerve (1.7%), and nerve root (3.8%) compression, basilar invagination (2.1%), hypercalcemia (5.2%), and congestive heart failure (3.0%). Hearing loss, noted in 61%, was significantly higher than previously reported. Conclusions: Compared with white Minnesota residents, overall survival was slightly better than expected (p = 0.010). No clinical risk factors were identified that were associated with an increased risk of death.

Original languageEnglish (US)
Pages (from-to)819-825
Number of pages7
JournalJournal of Bone and Mineral Research
Volume23
Issue number6
DOIs
StatePublished - Jun 1 2008

Keywords

  • Alkaline phosphatase
  • Epidemiology
  • Morbidity
  • Mortality
  • Paget's disease

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

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    Wermers, R. A., Tiegs, R. D., Atkinson, E. J., Achenbach, S. J., & Melton, L. J. (2008). Morbidity and mortality associated with Paget's disease of bone: A population-based study. Journal of Bone and Mineral Research, 23(6), 819-825. https://doi.org/10.1359/jbmr.080215