PDF(Pubmed)
Abstract：
UNASSIGNED: Transsphenoidal surgery (TSS) is the preferred surgical method for most pituitary adenomas owing to high efficacy and low mortality. This study aimed to evaluate the influence of metabolic syndrome (MetS) on postoperative outcomes of TSS for pituitary adenoma.
UNASSIGNED: This population-based, retrospective observational study extracted data of adults 20-79 y receiving TSS for pituitary adenoma from the US Nationwide Inpatient Sample (NIS) between 2005-2018. Primary outcomes were pituitary-related complications, poor outcomes (i.e., in-hospital mortality or unfavorable discharge), prolonged length of stay (LOS), and patient safety indicators (PSIs). Univariate and multivariate regressions were performed to determine the associations between study variables and outcomes.
UNASSIGNED: 19,076 patients (representing a 93,185 US in-patient population) were included, among which 2,109 (11.1%) patients had MetS. After adjustment, pre-existing MetS was not significantly associated with presence of pituitary-related complications and poor outcomes. In contrast, MetS was significantly associated with an increased risk for prolonged LOS (adjusted OR (aOR) = 1.19; 95% CI: 1.05-1.34), PSIs (aOR = 1.31; 95% CI: 1.07-1.59) and greater hospital costs (adjusted β = 8.63 thousand USD; 95% CI: 4.98-12.29). Among pituitary-related complications, MetS was independently associated with increased risk of cerebrospinal fluid (CSF) rhinorrhea (aOR = 1.22, 95% CI: 1.01, 1.47) but lowered diabetes insipidus (aOR = 0.83, 95% CI: 0.71, 0.97).
UNASSIGNED: MetS does not pose excessive risk of in-hospital mortality or unfavorable discharge. However, MetS independently predicted having PSIs, prolonged LOS, greater hospital costs, and CSF rhinorrhea. Study findings may help clinicians achieve better risk stratification before TSS.
UNASSIGNED: This population-based, retrospective observational study extracted data of adults 20-79 y receiving TSS for pituitary adenoma from the US Nationwide Inpatient Sample (NIS) between 2005-2018. Primary outcomes were pituitary-related complications, poor outcomes (i.e., in-hospital mortality or unfavorable discharge), prolonged length of stay (LOS), and patient safety indicators (PSIs). Univariate and multivariate regressions were performed to determine the associations between study variables and outcomes.
UNASSIGNED: 19,076 patients (representing a 93,185 US in-patient population) were included, among which 2,109 (11.1%) patients had MetS. After adjustment, pre-existing MetS was not significantly associated with presence of pituitary-related complications and poor outcomes. In contrast, MetS was significantly associated with an increased risk for prolonged LOS (adjusted OR (aOR) = 1.19; 95% CI: 1.05-1.34), PSIs (aOR = 1.31; 95% CI: 1.07-1.59) and greater hospital costs (adjusted β = 8.63 thousand USD; 95% CI: 4.98-12.29). Among pituitary-related complications, MetS was independently associated with increased risk of cerebrospinal fluid (CSF) rhinorrhea (aOR = 1.22, 95% CI: 1.01, 1.47) but lowered diabetes insipidus (aOR = 0.83, 95% CI: 0.71, 0.97).
UNASSIGNED: MetS does not pose excessive risk of in-hospital mortality or unfavorable discharge. However, MetS independently predicted having PSIs, prolonged LOS, greater hospital costs, and CSF rhinorrhea. Study findings may help clinicians achieve better risk stratification before TSS.
摘要：
■经蝶手术（TSS）是大多数垂体腺瘤的首选手术方法，因为它具有高疗效和低死亡率。本研究旨在评估代谢综合征（MetS）对垂体腺瘤TSS术后预后的影响。
■这种以人口为基础的，回顾性观察性研究从2005-2018年美国全国住院患者样本(NIS)中提取了20-79岁接受垂体腺瘤TSS治疗的成年人的数据.主要结果是垂体相关并发症，糟糕的结果(即，住院死亡率或不良出院)，延长住院时间(LOS)，和患者安全指标（PSIs）。进行单变量和多元回归以确定研究变量与结果之间的关联。
■包括19,076名患者（代表93,185名美国住院患者），其中2,109例（11.1％）患者患有MetS。调整后,预先存在的MetS与垂体相关并发症和不良结局无显著相关.相比之下,MetS与延长LOS的风险增加显着相关（校正OR（aOR）=1.19；95％CI：1.05-1.34），PSIs（aOR=1.31；95%CI：1.07-1.59）和更大的住院费用（调整后的β=8.63万美元；95%CI：4.98-12.29）。在垂体相关并发症中，MetS与脑脊液（CSF）鼻漏的风险增加独立相关（aOR=1.22，95％CI：1.01，1.47），但降低尿崩症（aOR=0.83，95％CI：0.71，0.97）。
■MetS不会造成院内死亡或不良出院的过度风险。然而,MetS独立预测具有PSI，延长的LOS，更高的医院费用，和脑脊液鼻漏。研究结果可能有助于临床医生在TSS之前更好地进行风险分层。
■这种以人口为基础的，回顾性观察性研究从2005-2018年美国全国住院患者样本(NIS)中提取了20-79岁接受垂体腺瘤TSS治疗的成年人的数据.主要结果是垂体相关并发症，糟糕的结果(即，住院死亡率或不良出院)，延长住院时间(LOS)，和患者安全指标（PSIs）。进行单变量和多元回归以确定研究变量与结果之间的关联。
■包括19,076名患者（代表93,185名美国住院患者），其中2,109例（11.1％）患者患有MetS。调整后,预先存在的MetS与垂体相关并发症和不良结局无显著相关.相比之下,MetS与延长LOS的风险增加显着相关（校正OR（aOR）=1.19；95％CI：1.05-1.34），PSIs（aOR=1.31；95%CI：1.07-1.59）和更大的住院费用（调整后的β=8.63万美元；95%CI：4.98-12.29）。在垂体相关并发症中，MetS与脑脊液（CSF）鼻漏的风险增加独立相关（aOR=1.22，95％CI：1.01，1.47），但降低尿崩症（aOR=0.83，95％CI：0.71，0.97）。
■MetS不会造成院内死亡或不良出院的过度风险。然而,MetS独立预测具有PSI，延长的LOS，更高的医院费用，和脑脊液鼻漏。研究结果可能有助于临床医生在TSS之前更好地进行风险分层。
