Clinical predictors of diabetes insipidus after transcranial surgery for pituitary adenoma
Abstract Objective Diabetes insipidus (DI) is a well-known complication of transsphenoidal pituitary adenoma surgery. However, the risk factors for DI after transcranial surgery have not been clarified. In this study, the clinical parameters for predicting DI after transcranial surgery were investig...
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| Veröffentlicht in: | World neurosurgery 2017-05, Vol.101, p.1-10 |
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| description | Abstract Objective Diabetes insipidus (DI) is a well-known complication of transsphenoidal pituitary adenoma surgery. However, the risk factors for DI after transcranial surgery have not been clarified. In this study, the clinical parameters for predicting DI after transcranial surgery were investigated. Method The perioperative records of 90 patients who underwent transcranial (TC) surgery at the authors’ institution between November 2011 and March 2013 were chosen from 1657 pituitary adenoma patients and retrospectively analyzed. The degree of deformation of the third ventricle and hypothalamus were assessed by preoperative magnetic resonance imaging (MRI). Result Immediate postoperative DI was found in 30 patients (33.3%). Persistent DI was noted in 11 patients (12.6%). Compared with patients in the nonpostoperative DI group, those with postoperative DI had a higher degree of deformation of the third ventricle and hypothalamus (p |
| doi_str_mv | 10.1016/j.wneu.2017.01.075 |
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However, the risk factors for DI after transcranial surgery have not been clarified. In this study, the clinical parameters for predicting DI after transcranial surgery were investigated. Method The perioperative records of 90 patients who underwent transcranial (TC) surgery at the authors’ institution between November 2011 and March 2013 were chosen from 1657 pituitary adenoma patients and retrospectively analyzed. The degree of deformation of the third ventricle and hypothalamus were assessed by preoperative magnetic resonance imaging (MRI). Result Immediate postoperative DI was found in 30 patients (33.3%). Persistent DI was noted in 11 patients (12.6%). Compared with patients in the nonpostoperative DI group, those with postoperative DI had a higher degree of deformation of the third ventricle and hypothalamus (p<0.001). In a binary logistic regression analysis, the degree of deformation of the third ventricle and hypothalamus (OR=3.079, 95% CI=1.600–5.925, p=0.001) had a significant positive correlation with immediate postoperative DI, as well as postoperative hemorrhage (OR=6.235, 95% CI=1.457–26.689, p=0.014). Postoperative hemorrhage (OR=4.363, 95% CI=1.021–18.647, p=0.047) showed a positive correlation with permanent DI, as well as the degree of deformation of the third ventricle and hypothalamus (OR=2.336, 95% CI=1.005–5.427, p=0.049). Conclusion The degree of deformation of the third ventricle and hypothalamus assessed by preoperative MRI may help to predict postoperative DI. Postoperative hemorrhage might increase the incidence of postoperative DI, whether it is immediate postoperative DI or permanent DI.</description><identifier>ISSN: 1878-8750</identifier><identifier>EISSN: 1878-8769</identifier><identifier>DOI: 10.1016/j.wneu.2017.01.075</identifier><identifier>PMID: 28153615</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenoma - epidemiology ; Adenoma - surgery ; Adult ; Diabetes insipidus ; Diabetes Insipidus - diagnosis ; Diabetes Insipidus - etiology ; Female ; Hemorrhage - etiology ; Humans ; Hypothalamus - diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurosurgery ; Neurosurgical Procedures - adverse effects ; Pituitary adenoma ; Pituitary Neoplasms - epidemiology ; Pituitary Neoplasms - surgery ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative hemorrhage ; Predictive Value of Tests ; Retrospective Studies ; Sphenoid Sinus - surgery ; Statistics, Nonparametric ; Third Ventricle - diagnostic imaging ; Transcranial surgery</subject><ispartof>World neurosurgery, 2017-05, Vol.101, p.1-10</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-2ef37282a77134d4596445d3443d2f08ec977628a6fc4b6ea1c96f9057b8323f3</citedby><cites>FETCH-LOGICAL-c477t-2ef37282a77134d4596445d3443d2f08ec977628a6fc4b6ea1c96f9057b8323f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.wneu.2017.01.075$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28153615$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Songquan, MD</creatorcontrib><creatorcontrib>Li, Deling, MD, PhD</creatorcontrib><creatorcontrib>Ni, Ming, MD, PhD</creatorcontrib><creatorcontrib>Jia, Wang, MD, PhD</creatorcontrib><creatorcontrib>Zhang, Qing, MD</creatorcontrib><creatorcontrib>He, Jue, MD</creatorcontrib><creatorcontrib>Jia, Guijun, MD, PhD</creatorcontrib><title>Clinical predictors of diabetes insipidus after transcranial surgery for pituitary adenoma</title><title>World neurosurgery</title><addtitle>World Neurosurg</addtitle><description>Abstract Objective Diabetes insipidus (DI) is a well-known complication of transsphenoidal pituitary adenoma surgery. However, the risk factors for DI after transcranial surgery have not been clarified. In this study, the clinical parameters for predicting DI after transcranial surgery were investigated. Method The perioperative records of 90 patients who underwent transcranial (TC) surgery at the authors’ institution between November 2011 and March 2013 were chosen from 1657 pituitary adenoma patients and retrospectively analyzed. The degree of deformation of the third ventricle and hypothalamus were assessed by preoperative magnetic resonance imaging (MRI). Result Immediate postoperative DI was found in 30 patients (33.3%). Persistent DI was noted in 11 patients (12.6%). Compared with patients in the nonpostoperative DI group, those with postoperative DI had a higher degree of deformation of the third ventricle and hypothalamus (p<0.001). In a binary logistic regression analysis, the degree of deformation of the third ventricle and hypothalamus (OR=3.079, 95% CI=1.600–5.925, p=0.001) had a significant positive correlation with immediate postoperative DI, as well as postoperative hemorrhage (OR=6.235, 95% CI=1.457–26.689, p=0.014). Postoperative hemorrhage (OR=4.363, 95% CI=1.021–18.647, p=0.047) showed a positive correlation with permanent DI, as well as the degree of deformation of the third ventricle and hypothalamus (OR=2.336, 95% CI=1.005–5.427, p=0.049). Conclusion The degree of deformation of the third ventricle and hypothalamus assessed by preoperative MRI may help to predict postoperative DI. Postoperative hemorrhage might increase the incidence of postoperative DI, whether it is immediate postoperative DI or permanent DI.</description><subject>Adenoma - epidemiology</subject><subject>Adenoma - surgery</subject><subject>Adult</subject><subject>Diabetes insipidus</subject><subject>Diabetes Insipidus - diagnosis</subject><subject>Diabetes Insipidus - etiology</subject><subject>Female</subject><subject>Hemorrhage - etiology</subject><subject>Humans</subject><subject>Hypothalamus - diagnostic imaging</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures - adverse effects</subject><subject>Pituitary adenoma</subject><subject>Pituitary Neoplasms - epidemiology</subject><subject>Pituitary Neoplasms - surgery</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative hemorrhage</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Sphenoid Sinus - surgery</subject><subject>Statistics, Nonparametric</subject><subject>Third Ventricle - diagnostic imaging</subject><subject>Transcranial surgery</subject><issn>1878-8750</issn><issn>1878-8769</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1rFTEYhYMottT-ARcySzd3mu9kQAS5VC0Uumi7cRNykzeS69zJmGSU_nsz3GsXLswiH3DO4c1zEHpLcE8wkVf7_vcES08xUT0mPVbiBTonWumNVnJ4-XwX-AxdlrLHbTHCtWKv0RnVRDBJxDn6th3jFJ0duzmDj66mXLoUOh_tDiqULk4lztEvpbOhQu5qtlNxbYvNU5b8HfJTF1Lu5liXWG17WQ9TOtg36FWwY4HL03mBHj9fP2y_bm7vvtxsP91uHFeqbigEpqimVinCuOdikJwLzzhnngaswQ1KSaqtDI7vJFjiBhkGLNROM8oCu0Dvj7lzTj8XKNUcYnEwjnaCtBRDtBSCEaxFk9Kj1OVUSoZg5hwPbWZDsFmxmr1ZsZoVq8HENKzN9O6Uv-wO4J8tfyE2wYejANovf0XIprgIk2s8M7hqfIr_z__4j92dOvkBT1D2aclT42eIKdRgc78Wu_ZKFMN40Jj9AZdgnmM</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Wang, Songquan, MD</creator><creator>Li, Deling, MD, PhD</creator><creator>Ni, Ming, MD, PhD</creator><creator>Jia, Wang, MD, PhD</creator><creator>Zhang, Qing, MD</creator><creator>He, Jue, MD</creator><creator>Jia, Guijun, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>Clinical predictors of diabetes insipidus after transcranial surgery for pituitary adenoma</title><author>Wang, Songquan, MD ; Li, Deling, MD, PhD ; Ni, Ming, MD, PhD ; Jia, Wang, MD, PhD ; Zhang, Qing, MD ; He, Jue, MD ; Jia, Guijun, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-2ef37282a77134d4596445d3443d2f08ec977628a6fc4b6ea1c96f9057b8323f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adenoma - epidemiology</topic><topic>Adenoma - surgery</topic><topic>Adult</topic><topic>Diabetes insipidus</topic><topic>Diabetes Insipidus - diagnosis</topic><topic>Diabetes Insipidus - etiology</topic><topic>Female</topic><topic>Hemorrhage - etiology</topic><topic>Humans</topic><topic>Hypothalamus - diagnostic imaging</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Neurosurgical Procedures - adverse effects</topic><topic>Pituitary adenoma</topic><topic>Pituitary Neoplasms - epidemiology</topic><topic>Pituitary Neoplasms - surgery</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative hemorrhage</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Sphenoid Sinus - surgery</topic><topic>Statistics, Nonparametric</topic><topic>Third Ventricle - diagnostic imaging</topic><topic>Transcranial surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Songquan, MD</creatorcontrib><creatorcontrib>Li, Deling, MD, PhD</creatorcontrib><creatorcontrib>Ni, Ming, MD, PhD</creatorcontrib><creatorcontrib>Jia, Wang, MD, PhD</creatorcontrib><creatorcontrib>Zhang, Qing, MD</creatorcontrib><creatorcontrib>He, Jue, MD</creatorcontrib><creatorcontrib>Jia, Guijun, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>World neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Songquan, MD</au><au>Li, Deling, MD, PhD</au><au>Ni, Ming, MD, PhD</au><au>Jia, Wang, MD, PhD</au><au>Zhang, Qing, MD</au><au>He, Jue, MD</au><au>Jia, Guijun, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical predictors of diabetes insipidus after transcranial surgery for pituitary adenoma</atitle><jtitle>World neurosurgery</jtitle><addtitle>World Neurosurg</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>101</volume><spage>1</spage><epage>10</epage><pages>1-10</pages><issn>1878-8750</issn><eissn>1878-8769</eissn><abstract>Abstract Objective Diabetes insipidus (DI) is a well-known complication of transsphenoidal pituitary adenoma surgery. However, the risk factors for DI after transcranial surgery have not been clarified. In this study, the clinical parameters for predicting DI after transcranial surgery were investigated. Method The perioperative records of 90 patients who underwent transcranial (TC) surgery at the authors’ institution between November 2011 and March 2013 were chosen from 1657 pituitary adenoma patients and retrospectively analyzed. The degree of deformation of the third ventricle and hypothalamus were assessed by preoperative magnetic resonance imaging (MRI). Result Immediate postoperative DI was found in 30 patients (33.3%). Persistent DI was noted in 11 patients (12.6%). Compared with patients in the nonpostoperative DI group, those with postoperative DI had a higher degree of deformation of the third ventricle and hypothalamus (p<0.001). In a binary logistic regression analysis, the degree of deformation of the third ventricle and hypothalamus (OR=3.079, 95% CI=1.600–5.925, p=0.001) had a significant positive correlation with immediate postoperative DI, as well as postoperative hemorrhage (OR=6.235, 95% CI=1.457–26.689, p=0.014). Postoperative hemorrhage (OR=4.363, 95% CI=1.021–18.647, p=0.047) showed a positive correlation with permanent DI, as well as the degree of deformation of the third ventricle and hypothalamus (OR=2.336, 95% CI=1.005–5.427, p=0.049). Conclusion The degree of deformation of the third ventricle and hypothalamus assessed by preoperative MRI may help to predict postoperative DI. Postoperative hemorrhage might increase the incidence of postoperative DI, whether it is immediate postoperative DI or permanent DI.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28153615</pmid><doi>10.1016/j.wneu.2017.01.075</doi><tpages>10</tpages></addata></record> |
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| subjects | Adenoma - epidemiology Adenoma - surgery Adult Diabetes insipidus Diabetes Insipidus - diagnosis Diabetes Insipidus - etiology Female Hemorrhage - etiology Humans Hypothalamus - diagnostic imaging Magnetic Resonance Imaging Male Middle Aged Neurosurgery Neurosurgical Procedures - adverse effects Pituitary adenoma Pituitary Neoplasms - epidemiology Pituitary Neoplasms - surgery Postoperative Complications - diagnosis Postoperative Complications - etiology Postoperative hemorrhage Predictive Value of Tests Retrospective Studies Sphenoid Sinus - surgery Statistics, Nonparametric Third Ventricle - diagnostic imaging Transcranial surgery |
| title | Clinical predictors of diabetes insipidus after transcranial surgery for pituitary adenoma |
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