Journal ArticleDOI
Delayed postoperative hyponatremia after transsphenoidal surgery: prevalence and associated factors.
Namath S. Hussain,Mackenzie Piper,W Grant Ludlam,William H. Ludlam,Cindy J. Fuller,Marc R. Mayberg +5 more
TLDR
Delayed postoperative hyponatremia was a common result of TSS; a low BMI was the only clear predictor of which patients will develop DPH and an appropriate index of suspicion and close postoperative monitoring of serum sodium concentration should be maintained for these patients.Abstract:
Object Transient delayed postoperative hyponatremia (DPH) after transsphenoidal surgery (TSS) is common and can have potentially devastating consequences. However, the true prevalence of transient symptomatic and asymptomatic DPH has not been studied in a large patient cohort with close and accurate follow-up. Methods A retrospective analysis of a single-institution prospective database was conducted; all patients undergoing TSS for lesions involving the pituitary gland were followed up in a multidisciplinary neuroendocrine clinic, and demographic, imaging, and clinical data were prospectively collected. Patients were examined preoperatively and followed up postoperatively in a standardized fashion, and their postoperative sodium levels were measured at Weeks 1 and 2 postoperatively. Levels of hyponatremia were rated as mild (serum sodium concentration 130–134 mEq/L), moderate (125–129 mEq/L), or severe (< 125 mEq/L). Routine clinical questionnaires were administered at all postoperative office visits. Po...read more
Citations
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Journal ArticleDOI
Delayed Hyponatremia Is the Most Common Cause of 30-Day Unplanned Readmission After Transsphenoidal Surgery for Pituitary Tumors.
Michael A. Bohl,Shah Ahmad,Heidi Jahnke,Deborah Shepherd,Laura Knecht,William L. White,Andrew S. Little +6 more
TL;DR: This study establishes a quality benchmark for readmission rates after transsphenoidal surgery for pituitary lesions and identifies delayed hyponatremia as the primary cause and developed an outpatient care pathway for managing hypon atremia with the goal of improving readmissions rates.
Journal ArticleDOI
A practical method for prevention of readmission for symptomatic hyponatremia following transsphenoidal surgery
William T. Burke,David J. Cote,Sherry Iuliano,Sherry Iuliano,Hasan A. Zaidi,Hasan A. Zaidi,Edward R. Laws,Edward R. Laws +7 more
TL;DR: Mandatory post-discharge fluid restriction to 1.0 L daily is a simple and inexpensive intervention associated with decreased rates of readmission for hyponatremia and normal post-operative sodium levels.
Journal ArticleDOI
Predictors and Rates of Delayed Symptomatic Hyponatremia after Transsphenoidal Surgery: A Systemastic Review
David J. Cote,Abdulaziz Ibrahim Alzarea,Michael A. Acosta,M. Maher Hulou,Kevin T. Huang,Hamoud Almutairi,Ahmad Alharbi,Hasan A. Zaidi,Majed Algrani,Ahmad Alatawi,Rania A. Mekary,Timothy R. Smith +11 more
TL;DR: By identifying patients at high risk for DSH, preventative efforts can be implemented in the perioperative setting to reduce the incidence of potentially catastrophic hyponatremia following transsphenoidal surgery.
Journal ArticleDOI
Prognostic importance of hyponatremia in acute ST-elevation myocardial infarction
TL;DR: Hyponatremia on admission or early development of hypon atremia in patients with acute ST-elevation myocardial infarction is an independent predictor of 30-day mortality, and prognosis worsens with the severity of hyp onatremian disease.
Journal ArticleDOI
Causes for 30-Day Readmission following Transsphenoidal Surgery:
TL;DR: The rate of 30-day readmission following endoscopic pituitary surgery is low, however, common causes of readmission do add significant cost to the overall care of this patient population.
References
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Journal ArticleDOI
Prevalence, predictors and patterns of postoperative polyuria and hyponatraemia in the immediate course after transsphenoidal surgery for pituitary adenomas.
TL;DR: This study was performed to examine the prevalence and predictors of polyuria and hyponatraemia after a complete and selective removal of pituitary adenomas was attempted via the transnasal–transsphenoidal approach.
Journal ArticleDOI
Complications of Endoscopic Surgery of the Pituitary Adenomas: Analysis of 570 Patients and Review of the Literature
Mustafa Berker,Derya Burcu Hazer,Taşkın Yücel,Alper Gürlek,Ayşenur Cila,M. M. Aldur,Metin Önerci +6 more
TL;DR: The complication rates observed in this study suggests that the endoscopic pituitary surgery is at least as safe as microscopic transphenoidal surgery.
Journal ArticleDOI
Complications in a contemporary series of patients who underwent transsphenoidal surgery for Cushing's disease
Patrick L. Semple,Edward R. Laws +1 more
TL;DR: The authors investigate the complications of transsphenoidal surgery in the treatment of a contemporary series of patients with Cushing's disease, and the mortality rate was found to be 0.9% and permanent morbidity was 1.8%.
Journal ArticleDOI
Copeptin, a marker of vasopressin, in abdominal obesity, diabetes and microalbuminuria: the prospective Malmö Diet and Cancer Study cardiovascular cohort
Sofia Enhörning,Lise Bankir,Nadine Bouby,J. Struck,Bo Hedblad,M Persson,Nils G. Morgenthaler,Peter M. Nilsson,Olle Melander +8 more
TL;DR: A relationship between a dysregulated vasopressin system and cardiometabolic risk is suggested, which could have implications for risk assessment and novel preventive treatments.
Journal ArticleDOI
Pathophysiology of hyponatremia after transsphenoidal pituitary surgery
TL;DR: Patients should be monitored closely for plasma sodium, plentiful dietary sodium replacement, mild fluid restriction, and attention to symptoms of hyponatremia during the first 2 weeks after transsphenoidal surgery.