ECE2024 Eposter Presentations Adrenal and Cardiovascular Endocrinology (155 abstracts)
Developing of a clinico-biological score to predict the diagnosis of cushing’s syndrome
Ameni Terzi 1 , Ibtissem Ouesleti 1 , Elyes Kammoun 1 , Yesmine Merhbene 1 , Meriem Mabrouk 1 , Arige Abid 1 , Meriem Yazidi 1 & Mélika Chihaoui 1
1Rabta, Endocrinology, Tunis
Introduction: Cushing’s syndrome (CS) has relevant morbidity and mortality and poses several diagnostic challenges underlining the need for a prompt diagnosis in order to initiate earlier treatment. The aim of the present study was to develop a new clinical and biological score to predict the diagnosis of CS.
Methods: This was a monocentric retrospective study including patients who were admitted to the Department of Endocrinology of La Rabta Hospital, Tunis for suspicion of CS. Clinical and biological data were collected from medical records. Univariate analysis was conducted to assess CS associated signs.
Results: One hundredtwo patients (69 women and 33 men) were enrolled in this study. Their mean age was 56.6 ± 14.7 years. The CS’s diagnosis was established in 63 patients (62%) and ruled out in 39 patients (38%). Proximal amyotrophy (OR : 9.88, IC95% : 1.2-78.8, P=0.010), headache (OR :2.93, IC95% :0.99-8.66, P=0.045), sleep disorders (OR = 9.22, IC95% : 2.02-42.06, P=0.001), and cortisol level after 1-mg dexamethasone suppression test (DST) > 5µg/dl (OR : 2.5, IC95% : 1.02-6.12, P=0.042) were associated with the diagnosis of CS. We developed a new score to predict CS based on four items including proximal amyotrophy (10 points), headache (3 points), sleep disorders (9 points) and cortisol level after DST > 5 µg/dl (2 points). The total score was 24 points. The total score median was 3 (Interquartile interval:0-12) in patients with CS and 0 (Interquartile interval:0-2) in patients without CS (P<0.001). This score had an area under the ROC curve of 0.746 (95%-CI: 0.65-0.842, P<0.001). A total score ≥12 points was positively associated with the diagnosis of CS (OR=12.9, 95% CI: 1.64-102.01, P=0.003). This cut-off had a specificity of 97% but a sensitivity of 25%.
Conclusion: In the present study, we generated a new score to establish the diagnosisof CS. This score was positively associated with the diagnosis of CS with a good specificity but a very low sensitivity.
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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