J Neurol Surg B Skull Base 2023; 84(S 01): S1-S344
DOI: 10.1055/s-0043-1762118
Presentation Abstracts
Oral Abstracts

Risk Factors for Development of Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) After Transsphenoidal Resection of Pituitary Adenoma

Gabrielle T. Petito
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Alex Hu
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Grace Zhang
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Susie Min
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Siddhant Tripathi
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Adithya Kumar
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Geet Shukla
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Sanjit Shah
2   Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, United States
,
Katie Phillips
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Suman Jana
3   Division of Endocrinology, Diabetes and Metabolism, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Jonathan A. Forbes
2   Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, United States
,
Mario Zuccarello
2   Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, United States
,
Norberto O. Andaluz
2   Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, United States
,
Ahmad R. Sedaghat
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
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Background: We aimed to determine the incidence and risk factors for development of diabetes insipidus (DI) and syndrome of inappropriate antidiuretic hormone secretion (SIADH) after transsphenoidal hypophysectomy (TSH) for resection of a pituitary adenoma.

Methods: This was a retrospective study of 403 adult patients undergoing TSH for pituitary adenoma. Clinical variables, tumor characteristics, and operative factors were collected. Incidences of DI and SIADH were determined, including timing in the perioperative period. Independent predictors of development of DI and SIADH were identified using multivariable logistic regression.

Results: Following TSH, 21.4% of patients developed DI at a mean 2.6 days and 7.4% developed SIADH at a mean 4.7 days. Development of DI was negatively associated with older age (OR = 0.98, 95% CI: 0.96–0.99, p = 0.029). Additionally, DI was positively associated with female sex (OR = 2.26, 95% CI: 1.24–4.11, p = 0.008), tumor size in the A-P dimension (OR = 1.54, 95% CI: 1.11–2.13, p = 0.010), intraoperative CSF leak (OR = 2.29, 95% CI: 1.25–4.19, p = 0.008), and every 100 mL of estimated blood loss (EBL) from the surgery (OR = 1.18, 95% CI: 1.01–1.39, p = 0.046). In contrast, a history of smoking tobacco, the Charlson Comorbidity Index, and a histopathologic description of the tumor as fibrous were not associated with development of DI. Our analysis did not find any clinical factors (age, sex, smoking history, comorbidities), tumor characteristics, or surgical factors to be associated with development of SIADH.

Conclusion: DI and SIADH occur in the minority of patients undergoing TSH, but vigilance for their development must be maintained for days after the surgery. Development of DI after TSH is multifactorial, having possible patient-specific risk factors (such as age and sex) as well as risk related to complexity of the surgical dissection, as reflected by tumor size, intraoperative CSF leak and EBL. By contrast, we did not find any clinical, tumor, or operative risk factors for development of SIADH.



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Artikel online veröffentlicht:
01. Februar 2023

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