Evidence map›Paper›PMID 35060011›Full record

ArticlePituitary2022

Characterization of a paradoxical post-operative increase in serum cortisol in Cushing disease.

Michael P Catalino, Aaron Gelinne, Natasha Ironside, Justin Coley, Rachel Jonas, Kathryn Kearns, Alexander Munoz, Alaa Montaser, Mary Lee Vance, John A Jane and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Pituitary, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Michael P CatalinoDepartment of Neurosurgery, University of North Carolina Hospitals, Chapel Hill, NC, USA. michael.catalino@unchealth.unc.edu.ORCID http://orcid.org/0000-0002-0411-6903
Aaron GelinneDepartment of Neurosurgery, University of North Carolina Hospitals, Chapel Hill, NC, USA.
Natasha IronsideDepartment of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA.
Justin ColeySchool of Medicine, University of Virginia, Charlottesville, VA, USA.
Rachel JonasDepartment of Otolaryngology, University of Virginia Health System, Charlottesville, VA, USA.
Kathryn KearnsSchool of Medicine, University of Virginia, Charlottesville, VA, USA.
Alexander MunozHarvard Medical School, MIT Health Sciences and Technology, Boston, MA, USA.
Alaa MontaserDepartment of Neurosurgery, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
Mary Lee VanceDivision of Endocrinology, University of Virginia Health System, Charlottesville, VA, USA.
John A JaneDepartment of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA.
Edward R LawsHarvard Medical School, MIT Health Sciences and Technology, Boston, MA, USA.
University of Virginia Health System · USHarvard University · USUniversity of Virginia · USBrigham and Women's Hospital · USUniversity of North Carolina Health Care · USUniversity of North Carolina Hospitals · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn Cushing disease, early post-operative serum cortisol fluctuations have not been adequately characterized, and their association with initial remission and recurrence is unclear.

methodsA retrospective cohort study of patients with Cushing disease was conducted at two institutions. A "riser" was defined a priori as a paradoxical increase in serum cortisol with an immediate incremental increase in serum cortisol over three consecutive cortisol draws separated by roughly 6-h (definition 1). Post hoc analyses used a definition of two consecutive increases (definition 2). Risers were compared to non-risers for initial remission and time-to-recurrence.

resultsA total of 505 patients with Cushing disease were screened, and 469 had adequate data for group assignment. Analysis of post-operative cortisol showed a subgroup of "risers" with a frequency of 3.6% for definition 1 and 42.6% for definition 2. In these patients, cortisol levels were significantly higher until approximately 36 h post-operatively, and cortisol had a significantly longer mean serum half-life. In the post hoc analysis, definition 2 risers had a lower remission rate compared to non-risers (162/196, 82.7%, versus 243/264, 92.0%) with an odds ratio of 0.41 (0.23-0.73; p = 0.003). For both definitions, recurrence was similar between groups.

conclusionsWe found that almost half of Cushing disease patients experienced a temporary increase in serum cortisol level during the early post-operative period. Serum cortisol half-life was longer, and the remission rates were lower, however, recurrence rates were similar to non-risers.

Indexed as

HydrocortisonePituitary ACTH HypersecretionHumansPostoperative PeriodRetrospective StudiesTreatment OutcomeHydrocortisoneCortisolCushing diseaseRecurrenceRemissionSurgery

Identifiers

PMID35060011
OpenAlexW4205867718

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.