Risk Factors and the Incidence of Diabetes Insipidus after Pituitary Surgery

Authors

  • Abdul Aziz Khan Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad
  • Ehtisham Ahmed Khan Afridi Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad
  • Sohail Ahmad Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad
  • Muhammad Wasim Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad
  • Meena Hayat Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad
  • Rafia Khurshid Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad

DOI:

https://doi.org/10.36552/pjns.v25i4.629

Keywords:

Diabetes Insipidus, Pituitary Adenoma, Macroadenoma, Giant Adenoma, Transsphenoidal Approach, Cranial Approach

Abstract

Background:  To improve patient care, determining the post-surgery risk factors for diabetes insipidus are extremely significant. We demonstrated the pre-operative factors and postoperative incidence of diabetes insipidus in pituitary surgery.

Materials and Methods:  Patients of both genders with ages between 18-65 years having pituitary adenoma amenable to surgery were included. The sample size mainly constitutes macroadenomas and giant adenomas i.e., greater than 1 cm and equal to or greater than 4 cm, respectively. The Hosmer-Lemeshow test was used to measure model fit. The receiver operator characteristic curve was used to evaluate the model and variables such as preoperative serum sodium and urine specific gravity.

Results:  Only 210 of 279 patients met the selection criteria. Most of the patients have lesions greater than 1cm, as a result of which a greater number of patients had undergone transcranial approach. Out of these patients, 27% have developed diabetes insipidus. The mean age was 53 years in the non-DI group, whereas, 47 years was the mean age in the patients with DI. 25% of females and 31% of males developed diabetes insipidus. 75% of females and 64% of males did not develop DI. The highest percentage (61%) of patients who developed DI came from giant adenomas. 

Conclusion:  Giant adenomas, aggressively primarily treated adenomas, and those lesions that were approached transcranially, showed an increased risk of diabetes insipidus and those who have undergone redo surgery have reduced incidence of diabetes insipidus.

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Published

2021-12-31

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Original Articles