Factors Associated with Postoperative Diabetes Insipidus after Pituitary Surgery

Antonio Jr. Lumbera Faltado; Anna Angelica Macalalad-Josue; Ralph Jason S. Li; John Paul M. Quisumbing; Marc Gregory Y. Yu; Cecilia A. Jimeno

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자료유형: 학술저널

저자정보: Antonio Jr. Lumbera Faltado (University of the Philippines) Anna Angelica Macalalad-Josue (University of the Philippines) Ralph Jason S. Li (University of the Philippines) John Paul M. Quisumbing (University of the Philippines) Marc Gregory Y. Yu (University of the Philippines) Cecilia A. Jimeno (University of the Philippines)

저널정보: 대한내분비학회 Endocrinology and Metabolism Endocrinology and Metabolism Vol.32 No.4

발행연도: 2017.1

수록면: 426 - 433 (8page)

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Background: Determining risk factors for diabetes insipidus (DI) after pituitary surgery is important in improving patient care. Our objective is to determine the factors associated with DI after pituitary surgery. Methods: We reviewed records of patients who underwent pituitary surgery from 2011 to 2015 at Philippine General Hospital. Patients with preoperative DI were excluded. Multiple logistic regression analysis was performed and a predictive model was generated. The discrimination abilities of the predictive model and individual variables were assessed using the receiving operator characteristic curve. Results: A total of 230 patients were included. The rate of postoperative DI was 27.8%. Percent change in serum Na (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.15 to 1.69); preoperative serum Na (OR, 1.19; 95% CI, 1.02 to 1.40); and performance of craniotomy (OR, 5.48; 95% CI, 1.60 to 18.80) remained significantly associated with an increased incidence of postoperative DI, while percent change in urine specific gravity (USG) (OR, 0.53; 95% CI, 0.33 to 0.87) and meningioma on histopathology (OR, 0.05; 95% CI, 0.04 to 0.70) were significantly associated with a decreased incidence. The predictive model generated has good diagnostic accuracy in predicting postoperative DI with an area under curve of 0.83. Conclusion: Greater percent change in serum Na, preoperative serum Na, and performance of craniotomy significantly increased the likelihood of postoperative DI while percent change in USG and meningioma on histopathology were significantly associated with a decreased incidence. The predictive model can be used to generate a scoring system in estimating the risk of postoperative DI.

참고문헌 (14)

참고문헌 신청

Zimmerman EA / 1976 / Hypothalamic neurons secreting vasopressin and neurophysin / Kidney Int 10:12~24

Singer PA / 2003 / Postoperative endocrine management of pituitary tumors / Neurosurg Clin N Am 14:123~138

Sheehan JM / 2006 / DDAVP use in patients undergoing transsphenoidal surgery for pituitary adenomas / Acta Neurochir (Wien) 148:287~291

1989 / Postoperative diabetes insipidus / BMJ 298:459

Black PM / 1987 / Incidence and management of complications of transsphenoidal operation for pituitary adenomas / Neurosurgery 20:920~924

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