Artikel
Living with Cushing’s disease – postoperative quality of life
Leben mit Morbus Cushing – postoperative Lebensqualität
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Autoren
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Sabrina Giese
- Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
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Isabella Nasi-Kordhishti
- Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
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Sophie Wang
- Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
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Jürgen B. Honegger
- Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
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Mirjam Renovanz
- Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
| Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Initial treatment of Cushing’s disease (CD) consists of transsphenoidal adenoma resection. In 80% of patients, endocrinological remission with elimination of hypercortisolism can be achieved. However, reduced quality of life (QoL) often persists despite successful surgical treatment.
Methods: 244 patients who had undergone transsphenoidal adenoma resection for Cushing's disease between 2007 and 2019 were contacted by postal mail. Patients received questionnaires addressing general and disease-specific QoL (Tuebingen CD-25 Inventory, Short-Form Healthy Survey [SF-36], Cushing´s Quality of Life Questionnaire [Cushing QoL]). A total of 86 patients (71 female, 13 male, 2 anonymous) who returned their questionnaires were included in the study. In particular, correlations of QoL with age, gender, and remission rates were analyzed. Both psychological and physical limitations were considered in the evaluation.
Results: Impaired physical health was age dependent. Only 14 of 38 women (37%) in the age group from 20-50 years showed evidence of physical limitations. In contrast, 23 of 37 women (62%) in the age group 50-80 years suffered from impaired physical activity. The results were different in the area of psychological health. Even younger patients showed emotional impairment and were less socially integrated. They considered that CD was responsible for impaired psychological health. The ability to manage everyday tasks differed between genders. 76.9% of male patients were able to cope with daily routine. In contrast, only 46.5% of female patients reported that they feel able to fulfill daily requirements. Interestingly, there was no significant correlation between QoL and remission status.
Conclusion: Prolonged psychological and physical impairments even after correction of hypercortisolism are an unsolved issue in CD. In our view, it is important to elucidate the need for support in patients who suffer from impaired QoL following TSS surgery and to establish patient-centered supportive programs.
