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Transsphenoidal surgery for pituitary tumours: frequency and predictors of delayed hyponatraemia and their relationship to early readmission
Transsphenoidal surgery for pituitary tumours: frequency and predictors of delayed hyponatraemia and their relationship to early readmission
- Source :
- European Journal of Endocrinology. 178:247-253
- Publication Year :
- 2018
- Publisher :
- Oxford University Press (OUP), 2018.
-
Abstract
- Objective A major cause of readmission after transsphenoidal surgery (TSS) is delayed hyponatraemia. The purpose of this study was to identify predictors of hyponatraemia one week post surgery and predictors of 30-day readmissions for hyponatraemia. Design A retrospective cohort study including patients who had TSS performed for pituitary lesions. Method The risk of readmission for hyponatraemia was assessed in consecutive patients between January 2008 and March 2016. The risk of hyponatraemia one week post surgery was assessed in patients admitted for TSS between July 2011 and March 2016. Results Of all included patients, 56/522 (10.7%) were readmitted within 30 days. Hyponatraemia was found in 14/56 (25%) of 30-day readmissions. We did not identify any predictive variable for hyponatraemia on readmission. The number of patients with hyponatraemia on the seventh post-operative day was 26/314 (8.3%). The risk of hyponatraemia one week post surgery was increased by an odds ratio of 2.40 (95% CI: 1.06–5.40) in patients with a tumour abutting the optic chiasm and by an odds ratio of 1.16 (1.04–1.31) per mmol/L decrease in sodium levels on the first post-operative day. Conclusions Hyponatraemia occurred in 25% of readmissions; however, we did not identify any predictive variable for readmission with hyponatraemia. One week post surgery, 8.9% had hyponatraemia. Tumours pressing on the optic chiasm as well as a fall in sodium levels on the first post-operative day were associated with an increased risk of hyponatraemia one week post surgery. We suggest that a day 7 serum sodium
- Subjects :
- Adenoma
Adult
Male
medicine.medical_specialty
Sphenoid Sinus
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
030209 endocrinology & metabolism
Pituitary neoplasm
Patient Readmission
Neurosurgical Procedures
Cohort Studies
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Endocrinology
Internal medicine
Sphenoid Bone
medicine
Humans
Pituitary Neoplasms
Pituitary tumours
Aged
Retrospective Studies
Transsphenoidal surgery
business.industry
nutritional and metabolic diseases
Retrospective cohort study
General Medicine
Odds ratio
Middle Aged
medicine.disease
Logistic Models
Multivariate Analysis
Female
Hyponatremia
business
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 1479683X and 08044643
- Volume :
- 178
- Database :
- OpenAIRE
- Journal :
- European Journal of Endocrinology
- Accession number :
- edsair.doi.dedup.....3786c6de407d3ad912fe1591a23975e5
- Full Text :
- https://doi.org/10.1530/eje-17-0879