Predictive factors for delayed hyponatremia after transsphenoidal surgery in patients with pituitary adenomas

Abstract

Objective: The aim of this study was to evaluate the incidence and duratio n of delayed hyponatremia and to assess the factors influencing the developme nt of delayed hyponatremia after transsphenoidal surgery (TSS) in pituitary a denomas. Methods: We retrospectively analyzed the clinical data of patients with pituitary adenoma who underwent TSS. Univariable and multivariable statistics wer e carried out to identify factors independently associated with the occurrence of delayed hyponatremia. Results: Of the 285 patients with pituitary adenoma who underwent micro scopic TSS, 44 (15.4%) developed postoperative-delayed hyponatremia and 241 (84.6%) did not. The onset of delayed hyponatremia occurred an average of 5.84 d ays post-surgery and persisted for an average of 5.36 days. Logistic regression anal ysis showed the highest risk of delayed hyponatremia in patients with significant change in tumor cavity height (odds ratio (OR), 1.158; 95% CI, 1.062, 1.262; P = 0.001), preoperative hypothalamus– pituitary–thyroid axis hypofunction (OR, 3.112; 95% CI, 1.481, 6.539; P = 0.003), and significant difference in blood sodium levels before and 2 days a fter TSS (OR, 1.101; 95% CI, 1.005, 1.206; P = 0.039). Conclusions: Preoperative hypothyroidism, difference in blood sodium levels before and 2 days after TSS, and the change in tumor cavity height after T SS played important roles in predicting postoperative-delayed hyponatremia onset in patients with pituitary adenomas.

Keywords

• hyponatremia
• hypothyroidism
• pituitary adenoma
• transsphenoidal surgery