In-Hospital Endocrinology Consultation After Transsphenoidal Surgery: Is It Always Necessary?
Patients with sellar masses undergoing transsphenoidal surgery (TSS) frequently develop endocrine dysfunction; therefore, in-hospital endocrinology consultation (IHEC) is recommended. However, we wondered whether routine endocrinology assessment of all TSS patients is always necessary. We developed...
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| Veröffentlicht in: | Canadian journal of neurological sciences 2021-07, Vol.48 (4), p.534-539 |
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| container_title | Canadian journal of neurological sciences |
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| creator | Clarke, David B. Hebb, Andrea L.O. Massoud, Emad Imran, Syed Ali |
| description | Patients with sellar masses undergoing transsphenoidal surgery (TSS) frequently develop endocrine dysfunction; therefore, in-hospital endocrinology consultation (IHEC) is recommended. However, we wondered whether routine endocrinology assessment of all TSS patients is always necessary.
We developed an IHEC Physician's Guide to identify patients who would require peri-operative IHEC. An analysis of all patients undergoing TSS for a sellar mass over a 4-year period was conducted to assess the predictive value of the IHEC Physician's Guide in identifying patients who required IHEC.
A total of 116 patients underwent TSS; 24 required IHEC. As expected, the risk of endocrine complications requiring peri-operative endocrine management was significantly higher in the IHEC group versus no-IHEC group (96% vs. 1%; p < 0.001). The negative predictive value of the IHEC Physician's Guide in identifying patients who did not require IHEC was 0.99 (95% CI 0.9409-0.9997); Fisher's exact test, p < 0.001), meaning that the IHEC Physician's Guide successfully identified all but one patient who truly required IHEC.
Results from our study show that most patients do not need IHEC after TSS and that those patients requiring IHEC can be reliably predicted at surgery by using a simple IHEC Physician's Guide. |
| doi_str_mv | 10.1017/cjn.2020.226 |
| format | Article |
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We developed an IHEC Physician's Guide to identify patients who would require peri-operative IHEC. An analysis of all patients undergoing TSS for a sellar mass over a 4-year period was conducted to assess the predictive value of the IHEC Physician's Guide in identifying patients who required IHEC.
A total of 116 patients underwent TSS; 24 required IHEC. As expected, the risk of endocrine complications requiring peri-operative endocrine management was significantly higher in the IHEC group versus no-IHEC group (96% vs. 1%; p < 0.001). The negative predictive value of the IHEC Physician's Guide in identifying patients who did not require IHEC was 0.99 (95% CI 0.9409-0.9997); Fisher's exact test, p < 0.001), meaning that the IHEC Physician's Guide successfully identified all but one patient who truly required IHEC.
Results from our study show that most patients do not need IHEC after TSS and that those patients requiring IHEC can be reliably predicted at surgery by using a simple IHEC Physician's Guide.</description><identifier>ISSN: 0317-1671</identifier><identifier>EISSN: 2057-0155</identifier><identifier>DOI: 10.1017/cjn.2020.226</identifier><identifier>PMID: 33059786</identifier><language>eng</language><publisher>New York, USA: Cambridge University Press</publisher><subject>Brain cancer ; Breast cancer ; Cysts ; Endocrinology ; Growth hormones ; Lung cancer ; Metastasis ; Multidisciplinary teams ; Multiple myeloma ; Neurosurgery ; Original Article ; Otolaryngology ; Patients ; Pituitary gland ; Surgery ; Thyroid cancer ; Tumors</subject><ispartof>Canadian journal of neurological sciences, 2021-07, Vol.48 (4), p.534-539</ispartof><rights>Copyright © The Author(s), 2020 .Published by Cambridge University Press on behalf of The Canadian Journal of Neurological Sciences Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c353t-6cf1b9ad819ad684e34957a3bae750cf77abd9c27e9b791dad5f875b1bd7da023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0317167120002267/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,776,780,27901,27902,55603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33059786$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clarke, David B.</creatorcontrib><creatorcontrib>Hebb, Andrea L.O.</creatorcontrib><creatorcontrib>Massoud, Emad</creatorcontrib><creatorcontrib>Imran, Syed Ali</creatorcontrib><title>In-Hospital Endocrinology Consultation After Transsphenoidal Surgery: Is It Always Necessary?</title><title>Canadian journal of neurological sciences</title><addtitle>Can. J. Neurol. Sci</addtitle><description>Patients with sellar masses undergoing transsphenoidal surgery (TSS) frequently develop endocrine dysfunction; therefore, in-hospital endocrinology consultation (IHEC) is recommended. However, we wondered whether routine endocrinology assessment of all TSS patients is always necessary.
We developed an IHEC Physician's Guide to identify patients who would require peri-operative IHEC. An analysis of all patients undergoing TSS for a sellar mass over a 4-year period was conducted to assess the predictive value of the IHEC Physician's Guide in identifying patients who required IHEC.
A total of 116 patients underwent TSS; 24 required IHEC. As expected, the risk of endocrine complications requiring peri-operative endocrine management was significantly higher in the IHEC group versus no-IHEC group (96% vs. 1%; p < 0.001). The negative predictive value of the IHEC Physician's Guide in identifying patients who did not require IHEC was 0.99 (95% CI 0.9409-0.9997); Fisher's exact test, p < 0.001), meaning that the IHEC Physician's Guide successfully identified all but one patient who truly required IHEC.
Results from our study show that most patients do not need IHEC after TSS and that those patients requiring IHEC can be reliably predicted at surgery by using a simple IHEC Physician's Guide.</description><subject>Brain cancer</subject><subject>Breast cancer</subject><subject>Cysts</subject><subject>Endocrinology</subject><subject>Growth hormones</subject><subject>Lung cancer</subject><subject>Metastasis</subject><subject>Multidisciplinary teams</subject><subject>Multiple myeloma</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Otolaryngology</subject><subject>Patients</subject><subject>Pituitary gland</subject><subject>Surgery</subject><subject>Thyroid cancer</subject><subject>Tumors</subject><issn>0317-1671</issn><issn>2057-0155</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNptkE1LAzEQhoMotlZvnmXBiwe35mOT7HqRUqoWih6sRwnZJFu3bJOa7CL996a0KoiXmcsz78w8AJwjOEQQ8Ru1tEMMMRxizA5AH0PKU4goPQR9SBBPEeOoB05CWEKIGWXZMegRAmnBc9YHb1ObPrqwrlvZJBOrnfK1dY1bbJKxs6FrWtnWziajqjU-mXtpQ1i_G-tqHQdeOr8wfnObTEMybZNR8yk3IXkyyoQg_ebuFBxVsgnmbN8H4PV-Mh8_prPnh-l4NEsVoaRNmapQWUido1hYnhmSFZRLUkrDKVQV57LUhcLcFCUvkJaaVjmnJSo11xJiMgBXu9y1dx-dCa1Y1UGZppHWuC4InFGUU4gIi-jlH3TpOm_jdQLzImMQwYxG6npHKe9C8KYSa1-v4ksCQbHVLqJ2sdUuovaIX-xDu3Jl9A_87TkCw32eXJW-1gvzu_bfxC8P8I1H</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Clarke, David B.</creator><creator>Hebb, Andrea L.O.</creator><creator>Massoud, Emad</creator><creator>Imran, Syed Ali</creator><general>Cambridge University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M0S</scope><scope>M2M</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PKEHL</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20210701</creationdate><title>In-Hospital Endocrinology Consultation After Transsphenoidal Surgery: Is It Always Necessary?</title><author>Clarke, David B. ; 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J. Neurol. Sci</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>48</volume><issue>4</issue><spage>534</spage><epage>539</epage><pages>534-539</pages><issn>0317-1671</issn><eissn>2057-0155</eissn><abstract>Patients with sellar masses undergoing transsphenoidal surgery (TSS) frequently develop endocrine dysfunction; therefore, in-hospital endocrinology consultation (IHEC) is recommended. However, we wondered whether routine endocrinology assessment of all TSS patients is always necessary.
We developed an IHEC Physician's Guide to identify patients who would require peri-operative IHEC. An analysis of all patients undergoing TSS for a sellar mass over a 4-year period was conducted to assess the predictive value of the IHEC Physician's Guide in identifying patients who required IHEC.
A total of 116 patients underwent TSS; 24 required IHEC. As expected, the risk of endocrine complications requiring peri-operative endocrine management was significantly higher in the IHEC group versus no-IHEC group (96% vs. 1%; p < 0.001). The negative predictive value of the IHEC Physician's Guide in identifying patients who did not require IHEC was 0.99 (95% CI 0.9409-0.9997); Fisher's exact test, p < 0.001), meaning that the IHEC Physician's Guide successfully identified all but one patient who truly required IHEC.
Results from our study show that most patients do not need IHEC after TSS and that those patients requiring IHEC can be reliably predicted at surgery by using a simple IHEC Physician's Guide.</abstract><cop>New York, USA</cop><pub>Cambridge University Press</pub><pmid>33059786</pmid><doi>10.1017/cjn.2020.226</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Brain cancer Breast cancer Cysts Endocrinology Growth hormones Lung cancer Metastasis Multidisciplinary teams Multiple myeloma Neurosurgery Original Article Otolaryngology Patients Pituitary gland Surgery Thyroid cancer Tumors |
| title | In-Hospital Endocrinology Consultation After Transsphenoidal Surgery: Is It Always Necessary? |
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