An integrated clinical score to predict remission in cushing's disease
Objective: To derive a clinical score from parameters that favor remission of Cushing's disease (CD) after pituitary surgery. Methods: This is an analysis of 11 clinical, hormonal, and post-operative parameters that each favored remission in a cohort of 145 patients with CD treated by trans-sph...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
|
| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2023;volume=27;issue=6;spage=501;epage=505;aulast=Gupta |
| _version_ | 1827345097212035072 |
|---|---|
| author | Nidhi Gupta Aditya Dutta Mintu Mani Baruah Anil Bhansali Chirag Kamal Ahuja Sivashanmugam Dhandapani Sanjay Kumar Bhadada Uma Nahar Saikia Rama Walia |
| author_facet | Nidhi Gupta Aditya Dutta Mintu Mani Baruah Anil Bhansali Chirag Kamal Ahuja Sivashanmugam Dhandapani Sanjay Kumar Bhadada Uma Nahar Saikia Rama Walia |
| author_sort | Nidhi Gupta |
| collection | DOAJ |
| description | Objective: To derive a clinical score from parameters that favor remission of Cushing's disease (CD) after pituitary surgery. Methods: This is an analysis of 11 clinical, hormonal, and post-operative parameters that each favored remission in a cohort of 145 patients with CD treated by trans-sphenoidal surgery (TSS). Each parameter was designated as a categorical variable (presence/absence), and several favorable parameters present for each patient were calculated. From this, a median parameter score (clinical score) of the entire cohort was derived, which was then compared to the event of remission/persistence of CD. Results: The median number of favorable parameters present in the entire cohort was 3 (0–7). The significant count of patients in remission increased with the increasing number of parameters. The receiver-operator characteristic curve showed that the presence of ≥3 parameters was associated with remission in CD with a sensitivity of 84.2% and a specificity of 80%. Patients with a clinical score ≥3 had significantly higher remission rates (88.9%) than those who had persistent disease (27.3%; P = 0.001).Conclusion: A clinical score of ≥3 predicts remission in CD treated by TSS; however, it requires validation in other large cohorts. Rather than assessing individual parameters to predict remission in CD, an integrated clinical score is a better tool for follow-up and patient counseling. |
| first_indexed | 2024-03-07T23:00:15Z |
| format | Article |
| id | doaj.art-8b6f7dab6ba64501a1b617d44f2a8111 |
| institution | Directory Open Access Journal |
| issn | 2230-8210 |
| language | English |
| last_indexed | 2024-03-07T23:00:15Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-8b6f7dab6ba64501a1b617d44f2a81112024-02-22T14:51:33ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102023-01-0127650150510.4103/ijem.ijem_314_23An integrated clinical score to predict remission in cushing's diseaseNidhi GuptaAditya DuttaMintu Mani BaruahAnil BhansaliChirag Kamal AhujaSivashanmugam DhandapaniSanjay Kumar BhadadaUma Nahar SaikiaRama WaliaObjective: To derive a clinical score from parameters that favor remission of Cushing's disease (CD) after pituitary surgery. Methods: This is an analysis of 11 clinical, hormonal, and post-operative parameters that each favored remission in a cohort of 145 patients with CD treated by trans-sphenoidal surgery (TSS). Each parameter was designated as a categorical variable (presence/absence), and several favorable parameters present for each patient were calculated. From this, a median parameter score (clinical score) of the entire cohort was derived, which was then compared to the event of remission/persistence of CD. Results: The median number of favorable parameters present in the entire cohort was 3 (0–7). The significant count of patients in remission increased with the increasing number of parameters. The receiver-operator characteristic curve showed that the presence of ≥3 parameters was associated with remission in CD with a sensitivity of 84.2% and a specificity of 80%. Patients with a clinical score ≥3 had significantly higher remission rates (88.9%) than those who had persistent disease (27.3%; P = 0.001).Conclusion: A clinical score of ≥3 predicts remission in CD treated by TSS; however, it requires validation in other large cohorts. Rather than assessing individual parameters to predict remission in CD, an integrated clinical score is a better tool for follow-up and patient counseling.http://www.ijem.in/article.asp?issn=2230-8210;year=2023;volume=27;issue=6;spage=501;epage=505;aulast=Guptaclinical scorecushing's diseaseremission |
| spellingShingle | Nidhi Gupta Aditya Dutta Mintu Mani Baruah Anil Bhansali Chirag Kamal Ahuja Sivashanmugam Dhandapani Sanjay Kumar Bhadada Uma Nahar Saikia Rama Walia An integrated clinical score to predict remission in cushing's disease Indian Journal of Endocrinology and Metabolism clinical score cushing's disease remission |
| title | An integrated clinical score to predict remission in cushing's disease |
| title_full | An integrated clinical score to predict remission in cushing's disease |
| title_fullStr | An integrated clinical score to predict remission in cushing's disease |
| title_full_unstemmed | An integrated clinical score to predict remission in cushing's disease |
| title_short | An integrated clinical score to predict remission in cushing's disease |
| title_sort | integrated clinical score to predict remission in cushing s disease |
| topic | clinical score cushing's disease remission |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2023;volume=27;issue=6;spage=501;epage=505;aulast=Gupta |
| work_keys_str_mv | AT nidhigupta anintegratedclinicalscoretopredictremissionincushingsdisease AT adityadutta anintegratedclinicalscoretopredictremissionincushingsdisease AT mintumanibaruah anintegratedclinicalscoretopredictremissionincushingsdisease AT anilbhansali anintegratedclinicalscoretopredictremissionincushingsdisease AT chiragkamalahuja anintegratedclinicalscoretopredictremissionincushingsdisease AT sivashanmugamdhandapani anintegratedclinicalscoretopredictremissionincushingsdisease AT sanjaykumarbhadada anintegratedclinicalscoretopredictremissionincushingsdisease AT umanaharsaikia anintegratedclinicalscoretopredictremissionincushingsdisease AT ramawalia anintegratedclinicalscoretopredictremissionincushingsdisease AT nidhigupta integratedclinicalscoretopredictremissionincushingsdisease AT adityadutta integratedclinicalscoretopredictremissionincushingsdisease AT mintumanibaruah integratedclinicalscoretopredictremissionincushingsdisease AT anilbhansali integratedclinicalscoretopredictremissionincushingsdisease AT chiragkamalahuja integratedclinicalscoretopredictremissionincushingsdisease AT sivashanmugamdhandapani integratedclinicalscoretopredictremissionincushingsdisease AT sanjaykumarbhadada integratedclinicalscoretopredictremissionincushingsdisease AT umanaharsaikia integratedclinicalscoretopredictremissionincushingsdisease AT ramawalia integratedclinicalscoretopredictremissionincushingsdisease |