Impact of metabolic syndrome on postoperative outcomes of transsphenoidal pituitary surgery: analysis of U.S. nationwide inpatient sample data 2005–2018

Jiun Lin Yan, Wan Chin Kan, Yi Hsien Kuo, Mao Yu Chen, Pin Yuan Chen, Kuan Hao Fu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

Abstract

Introduction: 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. Methods: 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. Results: 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). Discussion: 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.

Original languageEnglish
Article number1235441
Pages (from-to)1235441
JournalFrontiers in Endocrinology
Volume15
DOIs
StatePublished - 2024

Bibliographical note

Copyright © 2024 Yan, Kan, Kuo, Chen, Chen and Fu.

Keywords

  • in-hospital outcomes
  • metabolic syndrome (MetS)
  • nationwide inpatient sample (NIS)
  • pituitary adenoma
  • transsphenoidal pituitary surgery
  • Adenoma/surgery
  • Pituitary Diseases/epidemiology
  • Metabolic Syndrome/epidemiology
  • Humans
  • Pituitary Neoplasms/epidemiology
  • Inpatients
  • Postoperative Complications/epidemiology
  • Adult

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