Cluster Headache Decreases Life Expectancy: A Longitudinal Assessment During 40 Years in a Headache Clinic Cohort

Background: Cluster headache (CH) is one of the most disabling primary headaches. Nowadays, it is unknown if it has an impact on reducing life expectancy. Methods: We calculated years of potential life lost (YPLL) in deceased individuals from a CH registry of a third-level hospital, using as cutoff the estimated life expectancy for our general population according to their sex and year of death. Furthermore, a descriptive and comparative analysis of the main causes of death, risk factors, and toxic habits was carried out. Results: There were 25 deaths among the 152 individuals included. Twenty-one (84%) died earlier than expected with a mean of 9.14 YPLL (p=0.001). Cancer was the most common cause of death in CH patients (64% of deaths vs. 28.5% expected in general population, p <= 0.001). Eighty percent and 45% of our deceased patients were smokers and 60% and 45% regular alcohol consumers at the diagnosis of CH and at death, respectively. The percentage of smokers at diagnosis was significantly higher than that in the reference population (80% vs. 33.2%, p<0.001). There was a significantly higher frequency of arterial hypertension (76% vs. 19.82%, p<0.001) and diabetes mellitus (40% vs. 7.8%, p<0.001) at death in CH individuals compared to general population. Conclusions: CH implies a loss of almost one decade of life expectancy by an increase in cancer deaths. Tobacco and alcohol consumption seem to be the main underlying causes. These results call for an action plan for a better management of CH patients since their diagnosis.