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Intraoperative Diabetes Insipidus as a Predictor of Postoperative Complications Following Revascularization in

Jia Lu1, Qian Chen1, Xin Zhang2

  • 1Department of Anesthesia, Huashan Hospital, Fudan University, Shanghai, 200040, China.

Current Neurovascular Research
|February 26, 2026
PubMed
Abstract

Insights

Intraoperative diabetes insipidus (DI), high BMI, and ischemic moyamoya disease (MMD) predict postoperative complications after revascularization. High BMI also predicts intraoperative DI, aiding risk assessment for MMD patients.

Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Neurology

Background:

  • Surgical revascularization is effective for moyamoya disease (MMD) but carries risks like stroke and hyperperfusion syndrome.
  • Intraoperative diabetes insipidus (DI) is common but its clinical significance in MMD revascularization is unclear.
  • This study investigates risk factors for postoperative complications and the predictive value of intraoperative DI.

Purpose of the Study:

  • Identify risk factors for postoperative complications following MMD revascularization.
  • Evaluate the predictive value of intraoperative DI for postoperative complications.
  • Develop a predictive model for perioperative risk stratification in MMD patients.

Main Methods:

  • Retrospective analysis of 273 revascularization procedures for MMD.
  • Univariate and multivariate logistic regression to identify risk factors for postoperative complications.
  • Assessment of risk factors for intraoperative DI and construction of a nomogram-based predictive model.

Main Results:

  • Postoperative complications occurred in 42.4% (hyperperfusion syndrome) and 8.0% (stroke).
  • Intraoperative DI was present in 45.2% of cases and significantly associated with higher complication rates (p=0.02).
  • Independent predictors of complications included intraoperative DI (p=0.011), elevated BMI (p=0.032), and ischemic-type MMD (p=0.015). High BMI also predicted intraoperative DI.

Conclusions:

  • Intraoperative DI, elevated BMI, and ischemic-type MMD are independent predictors of postoperative complications in MMD revascularization.
  • The association between high BMI and intraoperative DI suggests a potential interaction and predictive relationship.
  • Incorporating these factors into perioperative assessment can improve risk stratification and preventative strategies for MMD patients.
Keywords:
BMIElectrolyte homeostasisMoyamoya diseaseintraoperative diabetes insipiduspostoperative complicationsrisk factor

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