Analysis of factors influencing the occurrence of diabetes insipidus following neuroendoscopic transsphenoidal resection of pituitary adenomas and risk assessment

Abstract

Objective: Studies have revealed a higher prevalence of diabetes insipidus in patients following resection of pituitary adenoma surgery. By comprehensively analysing the clinical history of patients undergoing endoscopic transnasal sphenoidal resection for pituitary adenomas, the factors influencing development of postoperative diabetes insipidus were investigated and a predictive model was developed to assess its risk. Methods: A retrospective analysis was conducted on the medical records of 281 patients with pituitary adenomas who underwent neuroendoscopic transsphenoidal resection at our institution between October 2020 and October 2022. The Mann-Whitney U test, chi-square test, and logistic regression analysis were used to identify the independent factors that potentially contribute to the development of postoperative diabetes insipidus. Additionally, a nomogram was constructed to evaluate the predicted risk of postoperative diabetes insipidus in patients with pituitary adenomas. Results: Diabetes insipidus occurred in 100 (35.59 %) of the 281 enrolled patients. The results of the multifactorial logistic regression analysis revealed that diabetes, hypertension, cardiopathy, preoperative serum cortisol level, cerebrospinal fluid leakage, and tumour texture independently influenced the occurrence of postoperative diabetes insipidus (P < 0.05). A nomogram was developed to evaluate the risk of postoperative diabetes insipidus in patients with pituitary adenoma. Conclusions: Multiple independent risk factors associated with the patient and tumour were identified in predicting diabetes insipidus. Early recognition of these risk factors may contribute to the prevention or reduction of diabetes insipidus incidence following pituitary adenoma surgery.

Keywords

• Pituitary adenoma
• Diabetes insipidus
• Relevant factors
• Nomograph