Basal cortisol in relation to metyrapone confirmation in predicting adrenal insufficiency after pituitary surgery
Authors' conclusion
Early morning plasma cortisol cut-off values lower than 450 nmol/L can safely be used to guide the need for hydrocortisone replacement after pituitary surgery.
Study context
- Population
- Patients after pituitary surgery with POD3 plasma cortisol < 450 nmol/L, given hydrocortisone replacement and metyrapone test at 3 months, Amsterdam UMC, January 2018–February 2022; Cushing's disease or preoperative hydrocortisone excluded
- Participants
- 95 patients
- Comparison
- POD3 early morning plasma cortisol vs metyrapone test (11-deoxycortisol) for postoperative adrenal insufficiency
- Outcome
- Adrenal insufficiency (11-deoxycortisol > 200 nmol/L)
Methodological detailssingle-centre
- Single-centre
Performance
As reported in the abstract
| Test or model | Value | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|---|
| Postoperative cortisol | 357 nmol/L | 100% | 31% | 32% | 100% |
Postoperative cortisol
Value357 nmol/L
Sensitivity100%
Specificity31%
PPV32%
NPV100%
- Reduction in need for hydrocortisone replacement vs current 450 nmol/L cut-off
- 28%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Basal cortisol in relation to metyrapone confirmation in predicting adrenal insufficiency after pituitary surgery. Pituitary. Published 19 January 2024. doi:10.
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