Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study

被引:6
作者
Yasuda, Marcos Ezequiel [1 ,2 ]
Renedo, Daniela [3 ]
Sosa, Soledad [4 ]
Danilowicz, Karina [4 ]
Recalde, Rodolfo [1 ]
Zaninovich, Roberto [1 ]
Abbati, Santiago Gonzalez [1 ]
Cervio, Andres [5 ]
Giovannini, Sebastian [5 ]
Villalonga, Juan [6 ]
Ulloque-Caamano, Liezel [6 ]
Reddy, Kesava [2 ]
Socolovsky, Mariano [1 ]
Campero, Alvaro [6 ]
机构
[1] Univ Buenos Aires, Hosp Clin Jose de San Martin, Sch Med, Dept Neurosurgy, Buenos Aires, Argentina
[2] McMaster Univ, Sch Med, Neurosurg Dept, Hamilton, ON, Canada
[3] Yale Sch Med, Dept Neurosurg, New Haven, CT USA
[4] Univ Buenos Aires, Hosp Clin Jose de San Martin, Sch Med, Endocrinol Dept, Buenos Aires, Argentina
[5] FLENI, Dept Neurosurg, Buenos Aires, Argentina
[6] Natl Univ Tucuman, Sch Med, Dept Neurosurg, LINT, San Miguel de Tucuman, Argentina
关键词
Adenohypophysis; Adenoma; Arginine vasopressin deficiency; ERAS; Neurosurgery; Neurohypophysis; Pituitary neoplasms; Diabetes insipidus; SURGERY; PREDICTORS; MANAGEMENT;
D O I
10.1016/j.wneu.2023.03.150
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
-OBJECTIVE: To analyze and find risk factors associated with developing transient diabetes insipidus (DI) using a multicenter case series after trans-sphenoidal surgery. -METHODS: Medical records of patients who underwent trans-sphenoidal surgery for pituitary adenoma resection between 2010 and 2021 at 3 different neurosurgical centers by 4 experienced neurosurgeons were retrospectively analyzed. The patients were divided into 2 groups (DI group or control group). Logistic regression analysis was conducted to identify risk factors associated with postoperative DI. Univariate logistic regression was performed to identify variables of interest. Covariates with a P value <0.05 were incorporated into multivariate logistic regression models to identify independently associated risk factors for DI. All statistical tests were conducted using RStudio. -RESULTS: A total of 344 patients were included; 68% were women, the mean age was 46.5 years, and nonfunctioning adenomas were the most frequent (171, 49.7%). The mean tumor size was 20.3 mm. Covariates associated with postoperative DI were age, female gender, and gross total resection. The multivariable model showed that age (odds ratio [OR] 0.97, CI 0.95-0.99, P = 0.017) and female gender (OR 2.92, CI 1.50-6.03, P = 0.002) remained significant predictors of DI development. Gross total resection was no longer a significant predictor of DI in the multivariable model (OR 1.86, CI 0.99-3.71, P = 0.063), suggesting that this variable may be confounded by other factors. -CONCLUSIONS: The independent risk factors for the development of transient DI were female and young patients.
引用
收藏
页码:E636 / E643
页数:8
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