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Войти в исследования Rhinology · 2020
Pathological changes from the originating to the peripheral sites of Sinonasal Inverted Papilloma are the underlying mechanisms of preoperative MRI-tumor origin prediction.
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Ma S, Xian M, Yang B, Fang G, Lou H, Yu W, Wang X, Xian J, Song X, Fan E, Li Y, Zhang L, Wang C
Аннотация
INTRODUCTION: Sheehan syndrome (SS) represents a rare cause of hypopituitarism. Data evaluating the quality of life (QoL) in women with SS are scarce. The aims of the present study were to evaluate the QoL in women with SS and to develop a clinical assessment score.
METHODS: This was a cross-sectional study including 62 women with hypopituitarism secondary to SS and 62 matched controls. QoL was evaluated using the 36-item Short Form Health Survey (SF-36). QoL was considered good if the SF-36 overall score was > 60. Factors associated with a good QoL were determined. A score including the factors associated with QoL was established and evaluated.
RESULTS: Patients mean age 64 ± 8.9 years. The mean duration of the disease was 31.7 ± 8.5 years with a mean diagnosis delay of 9.6 ± 9.1 years. The QoL was good in 29% of patients and 52% of controls (p=0.029). Factors associated with a good QoL were the age ≤ 60 years (OR=4; p=0.021), gravidity≤ 3 (OR=14; p<0.001), parity ≤ 3 (OR=2; p<0.001), delay in diagnosis < 5 years (OR=4; p=0.021), duration< 30 years (OR=3; p=0.034), estroprogestative treatment (OR=3; p=0.030), good therapeutic compliance (OR=3; p=0.049), and absence of adrenal crisis during follow-up (OR=4; p=0.020). We developed a score as the sum of these parameters weighted by their respective ORs. The mean score was 26.9 ± 7.4 in the patients with good QoL compared to 12.1 ± 9.4 in patients with impaired QoL (p< 0.001).The score had an area under the ROC curve of 0.885 (p<0.001; 95% CI: 0.799-0.971). A score ≥ 21 was positively associated with a good QoL with an OR of 31.7 (p<0.001; 95% CI: 7-143.2), a sensitivity of 83% and a specificity of 86%.
CONCLUSION: Women with hypopituitarism secondary to SS had significantly impaired QoL when compared to matched controls. The preliminary clinical score developed in this study may help assess QoL in women with Sheehan syndrome. Further validation in a larger sample size study is necessary to confirm its predictive value and facilitate its use in clinical practice.
METHODS: This was a cross-sectional study including 62 women with hypopituitarism secondary to SS and 62 matched controls. QoL was evaluated using the 36-item Short Form Health Survey (SF-36). QoL was considered good if the SF-36 overall score was > 60. Factors associated with a good QoL were determined. A score including the factors associated with QoL was established and evaluated.
RESULTS: Patients mean age 64 ± 8.9 years. The mean duration of the disease was 31.7 ± 8.5 years with a mean diagnosis delay of 9.6 ± 9.1 years. The QoL was good in 29% of patients and 52% of controls (p=0.029). Factors associated with a good QoL were the age ≤ 60 years (OR=4; p=0.021), gravidity≤ 3 (OR=14; p<0.001), parity ≤ 3 (OR=2; p<0.001), delay in diagnosis < 5 years (OR=4; p=0.021), duration< 30 years (OR=3; p=0.034), estroprogestative treatment (OR=3; p=0.030), good therapeutic compliance (OR=3; p=0.049), and absence of adrenal crisis during follow-up (OR=4; p=0.020). We developed a score as the sum of these parameters weighted by their respective ORs. The mean score was 26.9 ± 7.4 in the patients with good QoL compared to 12.1 ± 9.4 in patients with impaired QoL (p< 0.001).The score had an area under the ROC curve of 0.885 (p<0.001; 95% CI: 0.799-0.971). A score ≥ 21 was positively associated with a good QoL with an OR of 31.7 (p<0.001; 95% CI: 7-143.2), a sensitivity of 83% and a specificity of 86%.
CONCLUSION: Women with hypopituitarism secondary to SS had significantly impaired QoL when compared to matched controls. The preliminary clinical score developed in this study may help assess QoL in women with Sheehan syndrome. Further validation in a larger sample size study is necessary to confirm its predictive value and facilitate its use in clinical practice.