Cushing

Jayalekshmi Jayakumar; Manasa Ginjupalli; Neha Fatima; Roy Arya Mariam

doi:10.1530/endoabs.109.P45

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Endocrine Abstracts (2025) 109 P45 | DOI: 10.1530/endoabs.109.P45

SFEBES2025 Poster Presentations Adrenal and Cardiovascular (61 abstracts)

Cushing’s syndrome: a significant modifier of outcomes in lymphoma patients - a national inpatient sample analysis 2016-2020

Jayalekshmi Jayakumar ¹ , Manasa Ginjupalli ¹ , Neha Fatima ² & Arya Mariam Roy ³

Author affiliations

¹The Brooklyn Hospital Centre, Brooklyn, USA; ²North Middlesex Hospital, North Central London Deanery, London, United Kingdom; ³Ohio State University/The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, USA

Background: Cushing’s syndrome, characterised by elevated cortisol, weakens immune system and trigger chronic inflammation, potentially promoting lymphoma development. Previous studies indicate that adrenal tumours and pituitary adenomas can lead to both Cushing’s syndrome and lymphoma, suggesting a shared pathophysiology. Despite this, the link between cortisol excess and its effects on hospitalised lymphoma patients remains underexplored. This study aims to analyse the impact of Cushing’s syndrome on mortality, bleeding, and resource utilisation in lymphoma hospitalizations.

Methods: The National-Inpatient-Sample-database (2016-2020) was analyzed to identify adult lymphoma hospitalisations with Cushing’s syndrome, using ICD-10 codes. Chi-square tests assessed categorical variables, while t-tests evaluated continuous variables, with significance set at P < 0.05. Multivariate regression analysis examined the impact of Cushing’s disease on hospitalization outcomes in lymphoma, controlling for confounders, demographics, and hospital characteristics.

Results: 1,485,770 lymphoma hospitalizations were observed, 530 cases had Cushing’s syndrome. Average age of patients with Cushing’s was 59.13 years, vs 64.48 years for those without. Among Cushing’s patients, 61.54% were female. 65.69% were whites, 11.76% black, and 10.78% Hispanic (P = 0.05). Those with Cushing’s experienced higher resource utilisation, with an average increased length of stay by 3.75 days (10.61 vs 6.86) and costs by $46,451 (134,765$ vs 88,314$). Multivariate regression analysis showed that lymphoma hospitalizations with Cushing’s syndrome were linked to poorer outcomes, as detailed in the table.

Table 1. Impact of Cushing’s syndrome on lymphoma hospitalisations
	% with and without Cushing’s (p-value)	Adjusted-Odds-Ratio for confounders (95%-Confidence-Interval)	P-value
Mortality	10.37, 4.88 (P = 0.02)	2.90 (1.37-6.17)	0.005
Bleeding	13.20, 3.12 (P < 0.001)	4.91 (2.27-10.63)	<0.001

Conclusion: This study shows that Cushing’s syndrome negatively impacts hospitalisation outcomes in lymphoma patients, resulting in increased resource utilisation and higher mortality rates. Elevated risk of complications, like bleeding, highlights the need for effective management of Cushing’s. Further prospective studies should explore strategies to improve healthcare results in this population.