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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Disparities in Postoperative Endocrine Outcomes After Endoscopic-Assisted Transsphenoidal Pituitary Adenoma Resection
Chhitij Tiwari1, Eugene Maung1, Aaron Gelinne1
1Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Cureus
|December 30, 2022
Summary
Patients of Hispanic ethnicity and those in disadvantaged areas had higher rates of postoperative diabetes insipidus after pituitary adenoma surgery. These findings highlight socioeconomic disparities in surgical outcomes.
Area of Science:
- Neurosurgery
- Endocrinology
- Health Services Research
Background:
- Socioeconomic factors significantly impact patient morbidity.
- Pituitary adenomas require surgical intervention, with potential postoperative complications.
Purpose of the Study:
- To investigate the relationship between socioeconomic factors and postoperative outcomes in pituitary adenoma patients.
- To identify specific disparities in outcomes such as postoperative diabetes insipidus, hyponatremia, and hypopituitarism.
Main Methods:
- Retrospective chart review of adult patients undergoing pituitary adenoma resection (May 2014 - May 2020).
- Analysis of outcomes including postoperative diabetes insipidus (PDI), hyponatremia (PHN), and hypopituitarism (PHP).
- Multivariate and univariate analyses correlating outcomes with tumor volume, race/ethnicity, age, gender, Area Deprivation Index (ADI), and insurance status.
Main Results:
- Hispanic patients and those in more deprived neighborhoods showed increased incidence of PDI.
- Younger patients were more likely to experience PDI.
- Hispanic patients were younger and more likely to be uninsured.
- No significant correlations found for PHN or PHP.
Conclusions:
- Hispanic ethnicity and neighborhood deprivation are associated with higher PDI rates.
- Age and insurance status further complicate these observed healthcare disparities.
- Findings underscore the need for increased awareness and targeted resources for socioeconomically disadvantaged patients undergoing pituitary adenoma surgery.
