Factors Associated with Postoperative Diabetes Insipidus after Pituitary Surgery

Abstract

BackgroundDetermining 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.MethodsWe 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.ResultsA 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.ConclusionGreater 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.

WITHDRAWN: Risk Factors Related to Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Retrospective Cohort Study

“…2,9,18 Regarding surgical aspects, we did not nd any association with DI, and in the literature, there is no evidence that re-operation increases the incidence of transient or permanent DI. 20,26,29 Concerning the endoscopic or microscopic technique, the incidence of DI varies according to the series studied, although no signi cant difference was observed in our cohort. 26 According to some studies, a variation in serum sodium, either in percentage or absolute value, could be associated with an increased risk of developing DI.…”

“…However, Joshi et al described being male as a risk factor. 27 Furthermore, several studies 9,10,[26][27][28][29][30] found that sex is not associated with the development of DI. In our study, younger age was associated with a higher risk of presenting DI.…”

Prevalence of Endocrine Disorders in Childhood Brain Tumor Survivors in South Korea

“…However, in the study by Clement et al, DI occurred in more than 2.6% of their cohort. DI is typically diagnosed immediately after neurosurgery for low-grade gliomas or germ cell tumors (19).…”

The potential use of virgin coconut oil as an adjunctive treatment for COVID-19: A review

“…Essentially, everyone is encouraged to vaccinate themselves because it is safe to build protection against the virus and provide immunity after complete vaccine administration [44] . Aside from all the treatments presented, herbal medicines and natural products such as virgin coconut oil are observed to have antioxidant, anti-inflammatory, antiviral, and antifungal properties, which could benefit COVID-19 patients [45] . VCO contains a wide variety of phytochemical compounds capable of disintegrating the virus envelope, preventing the viral proteins in binding to the host membrane, and inhibiting the late maturation stage in the virus replication cycle [7] .…”