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Novel predictive scoring system for morbid hypothalamic obesity in patients with pediatric craniopharyngioma
Mohammed A Fouda1,2, David Zurakowski3, R Michael Scott4
1Department of Neurosurgery, Boston Children's Hospital, Boston, MA, USA. Mfouda1@jhmi.edu.
Insights
Pediatric craniopharyngioma patients older than 10, with high BMI, or papilledema face higher risks of morbid hypothalamic obesity. A new scoring system helps predict and manage this condition.
Area of Science:
- Pediatric Endocrinology
- Neuro-oncology
- Obesity Medicine
Background:
- Craniopharyngioma is a brain tumor affecting the pituitary gland and hypothalamus.
- Hypothalamic obesity is a serious complication following craniopharyngioma treatment.
- Identifying risk factors and management strategies is crucial for patient outcomes.
Purpose of the Study:
- Identify independent risk factors for morbid hypothalamic obesity in pediatric craniopharyngioma.
- Develop a predictive scoring system for morbid hypothalamic obesity.
- Propose a management algorithm to minimize obesity risk.
Main Methods:
- Retrospective analysis of pediatric craniopharyngioma patients treated at Boston Children's Hospital (1985-2017).
- Data analysis using IBM SPSS Statistics.
- Inclusion criteria applied to 90 out of 105 diagnosed patients.
Main Results:
- Morbid hypothalamic obesity observed in 31.1% of patients at last follow-up.
- Independent risk factors identified: age > 10 years at diagnosis (P=0.023), preoperative BMI > 95th percentile (P=0.006), and preoperative papilledema (P<0.001).
- Median age at diagnosis was 8.4 years; median follow-up was 10.6 years.
Conclusions:
- Age, preoperative BMI, and papilledema are significant predictors of morbid hypothalamic obesity.
- A novel predictive scoring system was developed to stratify risk.
- The study provides a foundation for a management algorithm to mitigate obesity risk.
Purpose:
To identify the independent risk factors for developing morbid hypothalamic obesity, to propose a predictive scoring system for morbid hypothalamic obesity, and to propose an algorithm for management in order to minimize the risk of developing morbid hypothalamic obesity in patients with pediatric craniopharyngioma.
Methods:
A retrospective analysis of all pediatric craniopharyngioma patients diagnosed and treated at Boston Children's Hospital (BCH) between 1985 and 2017. Analysis of the data was conducted using IBM SPSS Statistics.
Results:
We identified 105 patients, 90 (47 males and 43 females) fulfilled the inclusion criteria. The median age of patients at time of diagnosis was 8.4 years. The median follow-up was 10.6 years. Morbid hypothalamic obesity was evident in 28 (31.1%) patients at the last follow-up visit. Age of patients at time of diagnosis > 10 years (P = 0.023), preoperative body mass index (BMI) > 95th percentile (P = 0.006), and preoperative papilledema (P < 0.001) were the independent risk factors for developing morbid hypothalamic obesity.
Conclusion:
We developed a unique predictive scoring system in order to differentiate between patients with and without high risk for developing morbid hypothalamic obesity.
