The 1997 working party recommendations for the management of patients with pituitary tumours suggest formal assessment by an endocrinologist prior to tertiary referral. We have examined the extent of endocrine assessment in such patients performed both by endocrine and non-endocrine specialists in a large district general hospital. Using ICD 9 & 10 coding records on patients discharged between 1993 and 2000, we identified 60 patients with pituitary pathology. Of these, 16 had died by 2001, 12 did not have macroadenomas and records were unavailable in 3 patients giving a sample size for analysis of 29. Mean age was 59 years (21-93) with a variety of pituitary tumours receiving medical, surgical or X-ray treatment. Only 7 patients (24%) had ever seen an endocrinologist prior to tertiary referral and 11 (38%) are under the long-term follow-up of one. The % of appropriately assessed patients by each axis was as follows: Prolactin 100% by endocrinologists (76% by non-endocrinologists), ACTH 100 (33), TSH 100 (71), Gonadotrophins 71 (43), GH 57 (47) and ADH 100 (100). The recommendation of assessment by an endocrinologist prior to tertiary referral was not widely followed. The quality of work-up by non-endocrinologists was variable.
08 - 11 Apr 2002
British Endocrine Societies