PD03-04 A SIMPLE INTERVENTION TO INCREASE FUNCTIONAL EVALUATION OF THE ADRENAL INCIDENTALOMA

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD03-04 A SIMPLE INTERVENTION TO INCREASE FUNCTIONAL EVALUATION OF THE ADRENAL INCIDENTALOMA Jonathan Yu, David Barham, Alexandria Hertz, John Musser, and Frank Gould Jonathan YuJonathan Yu More articles by this author , David BarhamDavid Barham More articles by this author , Alexandria HertzAlexandria Hertz More articles by this author , John MusserJohn Musser More articles by this author , and Frank GouldFrank Gould More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003220.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons guidelines recommend adrenal incidentalomas undergo a biochemical workup. However, in a retrospective chart review at our institution performed in 2019, we found that only a quarter of adrenal incidentalomas underwent a complete workup. We sought to implement a simple intervention to improve clinician adherence to guidelines regarding evaluation of adrenal incidentalomas. METHODS: In 2019, all CT scans of the abdomen at our institution between April 2019 and September 2019 that included evaluation of the adrenal glands were reviewed. The final report was reviewed to identify adrenal incidentalomas diagnosed during this period. A retrospective chart review was performed to determine if patients with adrenal incidentalomas underwent a complete biochemical workup. In January 2020, we requested that radiologists at our institution include “Urology or endocrinology consultation recommended” in reports for identified adrenal incidentalomas. A second retrospective review was performed between February 2022 and August 2022. The main outcome measure was the number of adrenal incidentalomas that underwent a complete biochemical assessment. A paired t-test analysis was performed to compare the two groups. RESULTS: A total of 1,420 CT scans on 1,239 patients were reviewed between April 2019 and September 2019 and 1,542 CT scans on 1,408 patients between February 2022 and August 2022. 19 adrenal incidentalomas were identified in the pre-intervention group (2019). Of the 19 adrenal incidentalomas in the pre-intervention group, only 5 (26%) underwent a complete biochemical workup. In 2022, a total of 19 adrenal incidentalomas were identified. 11 of the 19 reports had recommendation for referral to Urology/Endocrinology or recommendation for further biochemical assessment. 8/11 (73%) of these patients underwent a full biochemical evaluation. Only 1 of 8 patients with adrenal incidentaloma that did not have the intervention included within the radiology report had a biochemical workup performed at follow up. We found that there were more patients that underwent a complete biochemical evaluation in the post-intervention group (p<0.001). CONCLUSIONS: More patients had the appropriate biochemical evaluation performed for an adrenal incidentaloma when the radiology report included “Urology or endocrinology consultation recommended”. This is a simple intervention that should be implemented at other treatment facilities to improve the quality of care for patients. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e75 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan Yu More articles by this author David Barham More articles by this author Alexandria Hertz More articles by this author John Musser More articles by this author Frank Gould More articles by this author Expand All Advertisement PDF downloadLoading ...