POSTOPERATIVE RISE IN SERUM SODIUM LEVEL, INDICATOR OF DIABETES INSIPIDUS AFTER PITUITARY ADENOMA SURGERY

Abstract

Objective: To study the efficacy of post operative rise in serum sodium level as indicator of diabetes insipidus after pituitary adenoma surgery. Study Design: Cross sectional analytical study: Place and Duration of Study: Departments of Neurosurgery and Biochemistry, Punjab Institute of Neurosciences/ Lahore General Hospital/Postgraduate Medical Institute/Ameer-uddin Medical College, from Mar 2016 to Dec 2017 in Ethical approval was obtained from hospital Ethics Committee. Methodology: Total number of 169 patients was enrolled for transsphenoidal surgery of their pituitary adenoma. Non probability consecutive sampling technique were used to collect the sample size. Data was calculated from all the patients regarding age, gender, duration of transsphenoidal surgery, postoperative evidence of diabetes insipidus by measuring rise in serum sodium level >145mEq. Chi square test was applied and analysis was done using SPSS version 23. Results: Overall, 169 (100%) patients were enrolled in this study. Gender distribution showed there were 115 (68%) males and 54 (32%) females. Post-operative transient was noted in 23 (13.6%) patients. Serum sodium level (specific) was observed in 157 (92.9%) patients. While, >145 mEq sensitive was observed 149 (88.2%) patients. The main outcome variable of this study was diabetes insipidus permanent, in our study, it was noted in 16 (9.5%) patients. There was no association between diabetes insipid us permanent and effect modifiers. Conclusion: Level of sodium >145mEq was very sensitive and specific test which can be used to predict the outcome after pituitary adenoma surgery in the form of Diabetes Insipidus.

Keywords

• diabetes insipidus
• hypernatremia
• hyponatremia
• hypotonic polyuria
• polydypsia
• pituitary adenoma
• postoperative sodium level increase