A simple scoring system for predicting the risk of delayed hyponatremia after endoscopic transsphenoidal surgery for pituitary adenomas.

Author:

Mo changhong1,Li Yangyang2,Liu Yi2,Zhao Ruijing1,Wang Hao2,Guo Wei2,Hu Jiliang2

Affiliation:

1. Jinan University

2. Shenzhen People's Hospital

Abstract

Abstract Backgrounds To identify high-risk patients for delayed postoperative hyponatremia (DPH) early, we constructed a simple and effective scoring system. Methods We retrospectively analyzed 141 consecutive patients who underwent endoscopic transsphenoidal surgery (TSS) from January 2019 to December 2022. Patients were divided into DPH group and non-DPH (NDPH) group based on whether hyponatremia occurred after the third postoperative day. Multivariable logistic regression analysis was conducted to determine the predictive factors of DPH, and a simple scoring system was constructed based on these predictors. Results Among 141 patients, 36 (25.5%) developed DPH. Multivariable logistic regression analysis showed that age ≥48 years (OR, 3.74; 95%CI, 1.14-12.21; P=0.029), Knosp grade ≥3 (OR, 5.17; 95%CI, 1.20-22.27; P=0.027), postoperative hypokalemia within three days (OR, 3.13; 95%CI, 1.05-9.33; P=0.040), a difference in blood sodium levels between the first and second day after surgery ≥1 mEq/L (OR, 3.65; 95%CI, 1.05-12.77; P=0.043), and postoperative diabetes insipidus (OR, 3.57; 95%CI, 1.16-10.96; P=0.026) were independent predictors of DPH. Conclusion This scoring system for predicting DPH has an area under the receiver operating characteristic curve (AUC) of 0.856 (95%CI, 0.787-0.925), indicating moderate to good predictive value for DPH in our cohort, but further prospective external validation is needed.

Publisher

Research Square Platform LLC

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