ECE2024 Poster Presentations Pituitary and Neuroendocrinology (120 abstracts)
Longterm-outcomes in patients with cushing’s disease vs non-functioning pituitary adenoma after pituitary surgery: an active-comparator cohort study
Roxana Wimmer 1 , Sara Germann 1 , Rahel Laager 1 , Beat Müller 1 , Philipp Schütz 1 , Nina Kaegi-Braun 1 & Alexander Kutz 1
1Aarau, University Department of Medicine, Clinic for Endocrinology, Diabetology, and Metabolism, Kantonsspital Aarau, Aarau, Switzerland and Medical Faculty of the University of Basel, Basel, Switzerland, Aarau, Switzerland
Objective: There is increasing evidence that multisystem morbidity in patients with Cushing’s disease (CD) is only partially reversible following treatment. We investigated complications from multiple organs in hospitalized patients with CD compared to patients with non-functioning pituitary adenoma (NFPA) after pituitary surgery.
Design: Population-based retrospective cohort study using data from the Swiss Federal Statistical Office between January 2012 and December 2020.
Methods: Through 1:5 propensity score matching, we compared hospitalized patients undergoing pituitary surgery for CD or NFPA, addressing demographic differences. The primary composite endpoint included all-cause mortality, major adverse cardiovascular events (i.e., myocardial infarction, unstable angina, heart failure, cardiac arrest, ischemic stroke), hospitalization for psychiatric disorders, sepsis, severe thromboembolic events, and fractures in need of hospitalization. Secondary endpoints comprised individual components of the primary endpoint and reintervention due to disease persistence or recurrence.
Results: After matching, 113 CD patients (mean age 45 years [SD, 15], 74.3% female) and 390 with NFPA (47 years [SD, 15], 69% female) were included and followed for a median of 54.2 months (IQR 1, 116) after surgery. CD presence was associated with a higher incidence rate of the primary endpoint (43.2 vs 16.4 events per 1,000 person-years, HR 2.55; 95% CI 1.44 to 4.52). CD patients also showed significantly increased hospitalization rates for psychiatric disorders (HR 4.53; 95% CI 2.06 to 9.99) and sepsis (HR 4.41; 95% CI 1.18 to 16.44).
Conclusion: Even after pituitary surgery, CD patients faced a higher hazard of complications, especially psychiatric hospitalization and sepsis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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