PATIENTS' PERCEPTION ON CLINICAL OUTCOME AND QUALITY OF LIFE AFTER A DIAGNOSIS OF CUSHING SYNDROME

被引:18
作者
Papoian, Vardan [1 ]
Biller, Beverly M. K. [2 ]
Webb, Susan M. [3 ,4 ,5 ]
Campbell, Karen K. [6 ]
Hodin, Richard A. [7 ]
Phitayakorn, Roy [7 ]
机构
[1] MedStar Washington Hosp Ctr, Dept Surg, Washington, DC USA
[2] Massachusetts Gen Hosp, Dept Med, Neuroendocrine Unit, Boston, MA 02114 USA
[3] IIB St Pau, Hosp St Pau, Endocrinol Med Dept, Madrid, Spain
[4] ISCIII, CIBERER, Unidad 747, Madrid, Spain
[5] Univ Autonoma Barcelona, E-08193 Barcelona, Spain
[6] Cushings Support & Res Fdn, Plymouth, MA USA
[7] Massachusetts Gen Hosp, Dept Surg, Endocrine Surg Unit, Boston, MA 02114 USA
关键词
LAPAROSCOPIC BILATERAL ADRENALECTOMY; CHANGE SYMPTOM RESOLUTION; LONG-TERM; PITUITARY-ADENOMAS; DISEASE; COMORBIDITIES; QUESTIONNAIRE; EPIDEMIOLOGY; METAANALYSIS; IMPAIRMENTS;
D O I
10.4158/EP15855.OR
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Excess cortisol production (Cushing syndrome, CS) is a chronic disease affecting many organ systems and impacting quality of life (QoL). This study analyzed factors associated with self-reported QoL, including aspects related to the diagnosis and treatment modalities of CS. Methods: In collaboration with the Cushing's Support and Research Foundation (CSRF), surveys using a validated QoL instrument were sent to CSRF members. Data were analyzed for associations between QoL and demographic, treatment, and disease factors. Results: A total of 269 patients completed the survey. Respondents were 89.9% female, and the mean age was 48 years (SD 12, range 16-76). Respondents visited a median of 4 physicians (range 1-40) prior to the diagnosis of CS, with a median of 5 years (mean 7, SD 5, range 1-30) to obtain a diagnosis, showing a statistically significant negative correlation (P < .001). In one-quarter of cases, someone other than a physician suggested the diagnosis. Multiple regression analysis demonstrated that remission status, time to diagnosis, radiation therapy, and hypopituitarism were significant predictors of QoL. There was no association between QoL and patient's sex, age, replacement steroid use, having follow-up with an endocrinologist, or surgical approach. Conclusion: This is one of the largest QoL studies of CS patients and provides information for treatment and education goals. It is notable that early diagnosis and treatment was the major predictor of better QoL after achieving remission from disease, highlighting the need for awareness about the disorder. Patients in remission had better QoL, emphasizing the importance of disease control.
引用
收藏
页码:51 / 67
页数:17
相关论文
共 32 条
[1]   Evaluation of depression, quality of life and body image in patients with Cushing's disease [J].
Alcalar, Nilufer ;
Ozkan, Sedat ;
Kadioglu, Pinar ;
Celik, Ozlem ;
Cagatay, Penbe ;
Kucukyuruk, Baris ;
Gazioglu, Nurperi .
PITUITARY, 2013, 16 (03) :333-340
[2]   Systematic review and meta-analysis of retroperitoneoscopic versus laparoscopic adrenalectomy [J].
Constantinides, V. A. ;
Christakis, I. ;
Touska, P. ;
Palazzo, F. F. .
BRITISH JOURNAL OF SURGERY, 2012, 99 (12) :1639-1648
[3]  
Dorn L D, 2000, Clin Nurs Res, V9, P420, DOI 10.1177/10547730022158672
[4]  
Duh QY, 2002, SURGERY, V132, P1068
[5]   Laparoscopic versus open adrenalectomy: Another look at outcome using the Clavien classification system [J].
Eichhorn-Wharry, Laura I. ;
Talpos, Gary B. ;
Rubinfeld, Ilan .
SURGERY, 2012, 152 (06) :1090-1095
[6]   Emotional disorders in patients with different types of pituitary adenomas and factors affecting the diagnostic process [J].
Flitsch, J ;
Spitzner, S ;
Lüdecke, DK .
EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES, 2000, 108 (07) :480-485
[7]   Quality of life after laparoscopic bilateral adrenalectomy for Cushing's disease [J].
Hawn, MT ;
Cook, D ;
Deveney, C ;
Sheppard, BC .
SURGERY, 2002, 132 (06) :1064-1068
[8]   Adrenalectomy may improve cardiovascular and metabolic impairment and ameliorate quality of life in patients with adrenal incidentalomas and subclinical Cushing's syndrome [J].
Iacobone, Maurizio ;
Citton, Marilisa ;
Viel, Giovanni ;
Boetto, Riccardo ;
Bonadio, Italo ;
Mondi, Isabella ;
Tropea, Saveria ;
Nitti, Donato ;
Favia, Gennaro .
SURGERY, 2012, 152 (06) :991-997
[9]   A prospective study of psychiatric and psychological aspects of Cushing's syndrome [J].
Kelly, WF ;
Kelly, MJ ;
Faragher, B .
CLINICAL ENDOCRINOLOGY, 1996, 45 (06) :715-720
[10]   Impaired health-related quality of life in Addison's disease - impact of replacement therapy, comorbidities and socio-economic factors [J].
Kluger, Nicolas ;
Matikainen, Niina ;
Sintonen, Harri ;
Ranki, Annamari ;
Roine, Risto P. ;
Schalin-Jantti, Camilla .
CLINICAL ENDOCRINOLOGY, 2014, 81 (04) :511-518