Fatigue trajectory and its associated factors in patients after pituitary adenoma surgery: a longitudinal study

One of the most often reported symptoms in postoperative pituitary adenoma patients is fatigue, which frequently results in decreased mobility and activity, negatively affecting their quality of life. Identify subgroups of patients after pituitary adenoma surgery with distinct fatigue trajectories and analyze the differences in their characteristics.

This longitudinal study enrolled patients with pituitary adenoma undergoing transsphenoidal surgery. Participants completed the Identity Consequences Fatigue Scale the day before surgery (baseline/T1) and 1 day (T2), 3 days (T3), 5 days (T4), 7 days (T5), 1 month (T6), and about 3 months after surgery (T7). Identify potential categories of their fatigue trajectories based on the growth mixture model (GMM). Multivariable regression models using baseline covariates collected on the day before surgery (T1) were used to identify risk factors for incident fatigue at 3 months and to predict the resolution of fatigue. The study has been reported in accordance with the STROBE checklist.

A total of 196 patients completed the baseline questionnaire, including demographics and clinical characteristics, and finally, 189 patients completed the follow-up investigation. Three potential categories of postoperative fatigue trajectories were identified in patients with pituitary adenoma: the no fatigue group (13.20%), the fatigue remission group (64.60%), and the persistent fatigue group (22.20%). Logistic regression analysis showed that engaging in high-intensity physical activity, being unemployed, having worse sleep, undergoing lumbar drainage, experiencing recurrence, and having low serum sodium concentration were the predictors of fatigue trajectory.

There is group heterogeneity in the trajectory of fatigue in patients with pituitary adenomas after surgery. It is recommended that healthcare providers develop individualized intervention programs based on the fatigue characteristics of postoperative patients.