Investigating the Clinical Appropriateness of Short Synacthen Testing and Utility of Pretest Cortisol to Predict Short Synacthen Testing Outcomes: A Tertiary Center Experience in Southeast Asia
Authors' conclusion
Our analysis showed that clinical features of AI do not reliably predict SST outcomes. We advocate careful assessment of the pretest probability of AI in patients referred for SST. A pretest cortisol level can reduce the number of SSTs, with cost savings implications.
Study context
- Population
- Patients undergoing short synacthen test (SST) at a tertiary centre in Southeast Asia, February 2022 to February 2023
- Participants
- 781 SSTs
- Outcome
- Adequate cortisol response on SST
Methodological detailssingle tertiary centre
- Single tertiary centre
Main finding
As reported in the abstract
- SSTs with adequate cortisol response
- 83.9%
- SSTs inappropriately indicated
- 50.2%
- Pretest cortisol 300 nmol/L predicted SST response, sensitivity
- 93%
- Cortisol <100 nmol/L confirmed adrenal insufficiency (AI), specificity
- 97.3%
- SSTs avoidable using these cortisol thresholds
- 302 (38.5%)
Observational data: associations, not effects.
Further findings
Indications for SST
- Postural hypotension
- 26.9%
- Exogenous glucocorticoid administration
- 14.2%
Original publication
Investigating the Clinical Appropriateness of Short Synacthen Testing and Utility of Pretest Cortisol to Predict Short Synacthen Testing Outcomes: A Tertiary Center Experience in Southeast Asia. Endocr Pract. Published 18 October 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →