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Title:           High prevalence of venous thrombotic events in Cushing's syndrome: data from ERCUSYN and details in relation to surgery
Subject:         DOI: 10.1093/ejendo/lvad176; European Journal of Endocrinology, 190, 1, 2023-12-26.; Abstract:  Objective: The aim of this study was to evaluate the prevalence of venous thromboembolism (VTE) in patients included in the European Registry on Cushing's syndrome (ERCUSYN), compare their clinical characteristics with those who did not develop VTE and identify risk factors for VTE. Design: A retrospective observational cohort study. Methods: Data extraction from the registry was taken on February, 7, 2022. At the time there were 2174 patients diagnosed with Cushing's syndrome (CS) and 95 VTEs were reported in the database. Results: Of 95 VTE events 70 (74%) were in pituitary-dependent CS patients, 12 (12.5%) in adrenal-dependant CS, 10 (10.5%) in ectopic CS, and 3 (3%) in CS due to other causes. Sex, 24-hour urinary free cortisol (UFC) value at diagnosis, as well as the number of operations remained statistically significant predictors of VTE. Of patients who were treated with at least one surgery, 12 (13%) VTE occurred before and 80 (87%) after the surgery. Nearly half of these VTEs occurred within six months since the operation (36; 45%). Over half of the centers that reported VTE did not routinely anticoagulate CS patients. Anticoagulation schemes varied widely. Conclusion: Patients with CS have an elevated risk of developing VTE for an extended period of time. From ERCUSYN cohort patients have higher risk for VTE if they need multiple surgeries to treat CS, are males and have high UFC values at the diagnosis of CS. Since there is no agreement on thromboprohpylaxis, a protocol for VTE prevention that is widely adopted appears to be necessary for patients with CS.
Keywords:        Cushing's syndrome; venous thromboembolism; risk factors; ERCUSYN
Author:          Kristina Isand
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      Title: High prevalence of venous thrombotic events in Cushing's syndrome: data from ERCUSYN and details in relation to surgery
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       Item: 
        Title: Introduction
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       Item: 
        Title: Subjects and methods
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        Children: 
         Item: 
          Title: Statistical analysis
          Destination: seclvad176-s1.1.1
       Item: 
        Title: Results
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        Children: 
         Item: 
          Title: Characteristics of CS patients diagnosed with VTE
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         Item: 
          Title: Additional information concerning VTEs requested from individual centers
          Destination: seclvad176-s2.2
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          Title: Centers routine thromboprophylaxis schemes
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       Item: 
        Title: Discussion
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       Item: 
        Title: Limitations and strengths of this study
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        Children: 
         Item: 
          Title: Limitations
          Destination: seclvad176-s4.1
         Item: 
          Title: Strengths
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       Item: 
        Title: Conclusion
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       Item: 
        Title: Acknowledgments
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       Item: 
        Title: Funding
        Destination: seclvad176-s6
       Item: 
        Title: Authors’ contributions
        Destination: seclvad176-s7
       Item: 
        Title: References
        Destination: reflist
   Info: 
    Title: High prevalence of venous thrombotic events in Cushing's syndrome: data from ERCUSYN and details in relation to surgery
    Author: Kristina Isand
    Subject: DOI: 10.1093/ejendo/lvad176; European Journal of Endocrinology, 190, 1, 2023-12-26.; Abstract:  Objective: The aim of this study was to evaluate the prevalence of venous thromboembolism (VTE) in patients included in the European Registry on Cushing's syndrome (ERCUSYN), compare their clinical characteristics with those who did not develop VTE and identify risk factors for VTE. Design: A retrospective observational cohort study. Methods: Data extraction from the registry was taken on February, 7, 2022. At the time there were 2174 patients diagnosed with Cushing's syndrome (CS) and 95 VTEs were reported in the database. Results: Of 95 VTE events 70 (74%) were in pituitary-dependent CS patients, 12 (12.5%) in adrenal-dependant CS, 10 (10.5%) in ectopic CS, and 3 (3%) in CS due to other causes. Sex, 24-hour urinary free cortisol (UFC) value at diagnosis, as well as the number of operations remained statistically significant predictors of VTE. Of patients who were treated with at least one surgery, 12 (13%) VTE occurred before and 80 (87%) after the surgery. Nearly half of these VTEs occurred within six months since the operation (36; 45%). Over half of the centers that reported VTE did not routinely anticoagulate CS patients. Anticoagulation schemes varied widely. Conclusion: Patients with CS have an elevated risk of developing VTE for an extended period of time. From ERCUSYN cohort patients have higher risk for VTE if they need multiple surgeries to treat CS, are males and have high UFC values at the diagnosis of CS. Since there is no agreement on thromboprohpylaxis, a protocol for VTE prevention that is widely adopted appears to be necessary for patients with CS.
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  Checksum: 5496bbd7
   Type: CRC32
  Checksum: 38862efd1871c7a36f2793be95a96ef0
   Type: MD5
  Checksum: 050ccfec625e7d48f3615299add66a37cda4b83d
   Type: SHA-1
  Checksum: dedddea1f3af482e1be1a014fc9d4508c054b5f94ad5f9bb3d78297d9b61a2e0
   Type: SHA-256