Endocrine Abstracts

Cushing’s syndrome (CS), is the prolonged exposure to excess cortisol within the body and has a significant negative prognostic impact if left untreated. There are several screening tests available for CS: urinary free cortisol (UFC), overnight dexamethasone suppression test (oDST), and late night salivary cortisol test (LNSC).

This audit evaluated the screening of patients for CS by the Manchester Royal Infirmary (MRI), in 2012 against guidelines provided by The Endocrine Society and the MRI hospital policy. The parameters assessed in this audit were: were patients screened for CS adequately, Were discordant results followed up, could medication have interfered with the result and were positive results managed properly. This audit also determined how well the tests provided correlated with each other as a means to assess their consistency in screening for CS.

The MRI clinical biochemistry department collated the data for all the patients who received screening tests for CS in 2012. Each patient was then assessed, using their records on Medisec to determine how suitable their management was. The correlation between UFC and oDST tests was calculated using patients who had both tests. The SPSS program was used to calculate the κ co-efficient which quantifies the correlation.

In 2012, 80 patients were screened for CS using UFC and oDST tests and although management was suitable on the whole, patient care could be improved in some areas. Recommendations from this audit will look at ways the impact of medication can be taken into account when screening. The κ co-efficient provides insight on the UFC and oDST correlation. This audit will discuss this result and its significance with regards to patient management.