Abstract：
OBJECTIVE: Pregnancy is a known risk factor for Pituitary Apoplexy (PA) but there is a lack of consistency in the literature regarding non-gestational risk factors responsible for PA.
METHODS: We did a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify the non-gestational risk factors associated with the development of PA in adult patients with pituitary adenoma. Also, we discuss here a case of an elderly female with pituitary macroadenoma who was initially planned for pituitary resection electively but underwent emergency surgery after she developed PA.
RESULTS: As per screening and eligibility criteria, seven studies with 4937 study participants were included in this systematic review out of which 490 (9.92%) patients had PA, including asymptomatic subclinical PA (SPA) and symptomatic clinical PA (CPA). The macroadenomas and negative staining of the tumor were found to be a significant risk factor consistently in multivariate analysis in three and two retrospective studies, respectively. However, the results were varied for any significant difference in the risk factors for apoplexy between SPA and CPA. Similarly, there was no consistency among the studies for risk factors significantly responsible for CPA or PA compared to controls.
CONCLUSIONS: No single non-gestational risk factor is solely responsible for the development of PA in a pituitary adenoma compared to the control population. Tumor size (macroadenoma) and the non-functioning status of the adenoma are the only significant factors contributing independently toward an apoplectic event in most patients. Such patients can be prioritized for early pituitary tumor resection.
METHODS: We did a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify the non-gestational risk factors associated with the development of PA in adult patients with pituitary adenoma. Also, we discuss here a case of an elderly female with pituitary macroadenoma who was initially planned for pituitary resection electively but underwent emergency surgery after she developed PA.
RESULTS: As per screening and eligibility criteria, seven studies with 4937 study participants were included in this systematic review out of which 490 (9.92%) patients had PA, including asymptomatic subclinical PA (SPA) and symptomatic clinical PA (CPA). The macroadenomas and negative staining of the tumor were found to be a significant risk factor consistently in multivariate analysis in three and two retrospective studies, respectively. However, the results were varied for any significant difference in the risk factors for apoplexy between SPA and CPA. Similarly, there was no consistency among the studies for risk factors significantly responsible for CPA or PA compared to controls.
CONCLUSIONS: No single non-gestational risk factor is solely responsible for the development of PA in a pituitary adenoma compared to the control population. Tumor size (macroadenoma) and the non-functioning status of the adenoma are the only significant factors contributing independently toward an apoplectic event in most patients. Such patients can be prioritized for early pituitary tumor resection.
摘要：
目的：妊娠是垂体卒中（PA）的已知危险因素，但有关非妊娠危险因素的文献缺乏一致性。
方法：我们根据PRISMA（系统评价和Meta分析的首选报告项目）指南进行了系统评价，以确定与成人垂体腺瘤患者PA发展相关的非妊娠危险因素。此外，我们在这里讨论一例患有垂体大腺瘤的老年女性患者，该患者最初计划选择性进行垂体切除，但在患PA后接受了紧急手术。
结果：根据筛选和资格标准，这项系统评价包括7项研究，其中4937名研究参与者，其中490名（9.92%）患者患有PA，包括无症状的亚临床PA（SPA）和有症状的临床PA（CPA）。在三个和两个回顾性研究的多变量分析中，发现大腺瘤和肿瘤的阴性染色是一个显著的危险因素。分别。然而,SPA和CPA在卒中危险因素方面存在显著差异,结果存在差异.同样，与对照组相比,导致CPA或PA发生显著危险因素的研究结果不一致.
结论：与对照组相比，垂体腺瘤中没有单一的非妊娠危险因素是PA发生的唯一原因。在大多数患者中，肿瘤大小（大腺瘤）和腺瘤的无功能状态是独立导致中风事件的唯一重要因素。此类患者可优先进行早期垂体瘤切除。
方法：我们根据PRISMA（系统评价和Meta分析的首选报告项目）指南进行了系统评价，以确定与成人垂体腺瘤患者PA发展相关的非妊娠危险因素。此外，我们在这里讨论一例患有垂体大腺瘤的老年女性患者，该患者最初计划选择性进行垂体切除，但在患PA后接受了紧急手术。
结果：根据筛选和资格标准，这项系统评价包括7项研究，其中4937名研究参与者，其中490名（9.92%）患者患有PA，包括无症状的亚临床PA（SPA）和有症状的临床PA（CPA）。在三个和两个回顾性研究的多变量分析中，发现大腺瘤和肿瘤的阴性染色是一个显著的危险因素。分别。然而,SPA和CPA在卒中危险因素方面存在显著差异,结果存在差异.同样，与对照组相比,导致CPA或PA发生显著危险因素的研究结果不一致.
结论：与对照组相比，垂体腺瘤中没有单一的非妊娠危险因素是PA发生的唯一原因。在大多数患者中，肿瘤大小（大腺瘤）和腺瘤的无功能状态是独立导致中风事件的唯一重要因素。此类患者可优先进行早期垂体瘤切除。
