Evidence map›Paper›PMID 36846212›Full record

ArticleJournal of the Endocrine Society2023

Cortisol and ACTH Measurements at Extubation From Pituitary Surgery Predicts Hypothalamic-Pituitary-Adrenal Axis Function.

David T Asuzu, Shyama Bhatt, Diana Nwokoye, Christina Hayes, Michaela Cortes, Raven McGlotten, Meg Keil, Christina Tatsi, Lynnette Nieman, Prashant Chittiboina

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the Endocrine Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

10 authors.

David T AsuzuSurgical Neurology Branch, National Institute of Neurological Diseases and Stroke, Bethesda, MD, USA.ORCID https://orcid.org/0000-0001-7011-479X
Shyama BhattNeurosurgery Unit for Pituitary and Inheritable Diseases, National Institute of Neurological Diseases and Stroke, Bethesda, MD, USA.
Diana NwokoyeNeurosurgery Unit for Pituitary and Inheritable Diseases, National Institute of Neurological Diseases and Stroke, Bethesda, MD, USA.
Christina HayesSurgical Neurology Branch, National Institute of Neurological Diseases and Stroke, Bethesda, MD, USA.
Michaela CortesSurgical Neurology Branch, National Institute of Neurological Diseases and Stroke, Bethesda, MD, USA.
Raven McGlottenNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.ORCID https://orcid.org/0000-0001-5817-9232
Meg KeilSection on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Christina TatsiSection on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.ORCID https://orcid.org/0000-0002-2882-4584
Lynnette NiemanNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Prashant ChittiboinaSurgical Neurology Branch, National Institute of Neurological Diseases and Stroke, Bethesda, MD, USA.ORCID https://orcid.org/0000-0001-9349-4756

Funding

Improved Diagnosis and Treatment of Cushing's DiseaseZIANS003150 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI CHITTIBOINA, PRASHANT · 2015 to 2025
$13.7M
The differential diagnosis and treatment of Cushing's syndromeZIADK075122 · NIDDK · NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES · PI NIEMAN, LYNNETTE · 2016 to 2025
$4.0M
6 · The paper itself

Abstract

Context: Early prediction of hypothalamic-pituitary-adrenal (HPA) axis function following transsphenoidal surgery (TSS) can improve patient safety and reduce costs. Objective: Systematic measurement of ACTH and cortisol at extubation following anesthesia to predict remission from Cushing's disease (CD) and HPA axis preservation following non-CD surgery. Design: Retrospective analysis of clinical data between August 2015 and May 2022. Setting: Referral center. Patients: Consecutive patients (n = 129) undergoing TSS who had perioperative ACTH and cortisol measurements. Interventions: ACTH and cortisol measurement at extubation. Further serial 6-hourly measurements in CD patients. Main outcome measures: Prediction of future HPA axis status based on ACTH/cortisol at extubation. Results: ACTH and cortisol increased sharply in all patients at extubation. CD patients (n = 101) had lower ACTH values than non-CD patients (110.1 vs 293.1 pg/mL; Conclusions: We found that at extubation following TSS, ACTH can predict the need for eventual steroid replacement in non-Cushing's patients. In patients with CD, we found a robust prediction of nonremission with NEPV cortisol at extubation and later.

Indexed as

Cushing's diseasehypercortisolismpituitary adenomaremissiontranssphenoidal surgery

Identifiers

PMID36846212
PMCPMC9954986

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.