Session: MON 88-111-Cushing's Disease & Non-Functioning Hypothalamus-Pituitary Tumors
Poster Board MON-93
Objective: To evaluate and identify predictors for QoL in patients with treated CD.
Methods: A retrospective chart review was conducted of 362 patients who underwent transsphenoidal surgery for CD by a single surgeon. Ninety-three patients (73 women, 20 men, mean age at follow up 50.3 ± 14.7 years, mean time since surgery 7.55 ± 6.03 years) were contacted by phone to complete four mail-in surveys, including a medical history questionnaire and three validated quality of life assessments: Cushing’s QoL Questionnaire (CushingQoL), Hospital Anxiety and Depression Scale (HADS), and Nottingham Health Profile (NHP). Patients were divided into self-identified remission (N=75) and persistent disease (N=18) groups. Mean QoL scores were compared between the two groups with unpaired t-tests. Pearson’s correlation was performed in the whole cohort to assess for predictors of impaired QoL.
Results: Patients with treated CD experienced poor energy (57%), memory (48%) and concentration (43%), difficulty losing weight (49%), anxiety (43%) and depression (34%). Mean CushingQoL score was 57.2 ± 22.6 (0 = worst, 100 = best). When compared to patients with persistent disease, those in remission reported greater CushingQoL (p=0.005) and less depression (p=0.015) but had higher levels of anxiety (p=0.039). BMI negatively correlated with CushingQoL (p=0.009) but positively correlated with general health (p=0.0001). Recovery duration negatively correlated with CushingQoL (p=0.004) and positively correlated with depression (p=0.005) and general health (p=0.002).
Conclusions: Even after treatment, patients with CD reported persistent physical and psychological limitations. Self-assessed remission was associated with less depression but more anxiety compared to persistent disease. Recovery duration, although often viewed as a marker of successful treatment, was associated with reduced QoL and greater depression. These parameters may be helpful in identifying at-risk subgroups for psychological comorbidities. Continued evaluation of QoL and its predictors is needed to better understand paradoxical QoL changes that occur in treated CD patients.
Nothing to Disclose: AC, NKS, SC, LGA, JKL, KDP, EBG
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