Estimating mortality in rare diseases using a population-based registry, 2002 through 2019

Abstract Background Rare diseases (RD) are a heterogeneous group of diseases, sharing aspects of complexity. Prognosis is variable, even in individuals with the same disease. Real-world data on RD as a whole are scarce. The aim of this study is to provide data on mortality and survival for a substan...

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Main Authors: Monica Mazzucato, Laura Visonà Dalla Pozza, Cinzia Minichiello, Ema Toto, Andrea Vianello, Paola Facchin
Format: Article
Language:English
Published: BMC 2023-11-01
Series:Orphanet Journal of Rare Diseases
Subjects:
Online Access:https://doi.org/10.1186/s13023-023-02944-7
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author Monica Mazzucato
Laura Visonà Dalla Pozza
Cinzia Minichiello
Ema Toto
Andrea Vianello
Paola Facchin
author_facet Monica Mazzucato
Laura Visonà Dalla Pozza
Cinzia Minichiello
Ema Toto
Andrea Vianello
Paola Facchin
author_sort Monica Mazzucato
collection DOAJ
description Abstract Background Rare diseases (RD) are a heterogeneous group of diseases, sharing aspects of complexity. Prognosis is variable, even in individuals with the same disease. Real-world data on RD as a whole are scarce. The aim of this study is to provide data on mortality and survival for a substantial group of RD deriving from a population-based registry, which covers the Veneto region in Italy (4.9 million inhabitants). Results During the study period, 3367 deaths occurred, mainly in males (53.9%), elderly patients (63.5%) and patients with diseases having a reported prevalence of 1–9/100000 (65.6%). When standardizing by age, the mortality ratio was higher in RD patients than in the general population, SMR = 1.93 (95% CI 1.84–2.11), with an observed gender difference, 2.01 (95% CI 1.88–2.29) in females and 1.86 (95% CI 1.73–2.10) in males. The lowest survival rates are experienced by patients with rare neurologic diseases, rare skin diseases and rare systemic or rheumatologic diseases, 58%, 68% and 81%, respectively, after a 15-year observation period. It should be noted that only 18% of patients diagnosed with motor neuron diseases were alive after 15 years from diagnosis. Conclusions Despite progress in diagnosis, treatment and care in recent years, RD patients globally have higher mortality rates and reduced survival compared to the general population, with specific variations according to gender, age and disease group.
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spelling doaj.art-c36e32bded324fa0b3dd34a489fdd3552024-03-05T20:19:54ZengBMCOrphanet Journal of Rare Diseases1750-11722023-11-0118111110.1186/s13023-023-02944-7Estimating mortality in rare diseases using a population-based registry, 2002 through 2019Monica Mazzucato0Laura Visonà Dalla Pozza1Cinzia Minichiello2Ema Toto3Andrea Vianello4Paola Facchin5Rare Diseases Coordinating Centre, Veneto Region, Padua University HospitalRare Diseases Coordinating Centre, Veneto Region, Padua University HospitalRare Diseases Coordinating Centre, Veneto Region, Padua University HospitalRare Diseases Coordinating Centre, Veneto Region, Padua University HospitalDepartment of Child and Maternal Health, Padua University Hospital, University of PadovaRare Diseases Coordinating Centre, Veneto Region, Padua University HospitalAbstract Background Rare diseases (RD) are a heterogeneous group of diseases, sharing aspects of complexity. Prognosis is variable, even in individuals with the same disease. Real-world data on RD as a whole are scarce. The aim of this study is to provide data on mortality and survival for a substantial group of RD deriving from a population-based registry, which covers the Veneto region in Italy (4.9 million inhabitants). Results During the study period, 3367 deaths occurred, mainly in males (53.9%), elderly patients (63.5%) and patients with diseases having a reported prevalence of 1–9/100000 (65.6%). When standardizing by age, the mortality ratio was higher in RD patients than in the general population, SMR = 1.93 (95% CI 1.84–2.11), with an observed gender difference, 2.01 (95% CI 1.88–2.29) in females and 1.86 (95% CI 1.73–2.10) in males. The lowest survival rates are experienced by patients with rare neurologic diseases, rare skin diseases and rare systemic or rheumatologic diseases, 58%, 68% and 81%, respectively, after a 15-year observation period. It should be noted that only 18% of patients diagnosed with motor neuron diseases were alive after 15 years from diagnosis. Conclusions Despite progress in diagnosis, treatment and care in recent years, RD patients globally have higher mortality rates and reduced survival compared to the general population, with specific variations according to gender, age and disease group.https://doi.org/10.1186/s13023-023-02944-7Rare diseasesEpidemiologyPublic healthMortalitySurvivalORPHAcodes
spellingShingle Monica Mazzucato
Laura Visonà Dalla Pozza
Cinzia Minichiello
Ema Toto
Andrea Vianello
Paola Facchin
Estimating mortality in rare diseases using a population-based registry, 2002 through 2019
Orphanet Journal of Rare Diseases
Rare diseases
Epidemiology
Public health
Mortality
Survival
ORPHAcodes
title Estimating mortality in rare diseases using a population-based registry, 2002 through 2019
title_full Estimating mortality in rare diseases using a population-based registry, 2002 through 2019
title_fullStr Estimating mortality in rare diseases using a population-based registry, 2002 through 2019
title_full_unstemmed Estimating mortality in rare diseases using a population-based registry, 2002 through 2019
title_short Estimating mortality in rare diseases using a population-based registry, 2002 through 2019
title_sort estimating mortality in rare diseases using a population based registry 2002 through 2019
topic Rare diseases
Epidemiology
Public health
Mortality
Survival
ORPHAcodes
url https://doi.org/10.1186/s13023-023-02944-7
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AT ematoto estimatingmortalityinrarediseasesusingapopulationbasedregistry2002through2019
AT andreavianello estimatingmortalityinrarediseasesusingapopulationbasedregistry2002through2019
AT paolafacchin estimatingmortalityinrarediseasesusingapopulationbasedregistry2002through2019