Influencing factor analysis of perioperative hyponatremia in patients with pituitary adenoma

Abstract

Objective To investigate the factors influencing perioperative hyponatremia in patients with pituitary adenomas. Methods We retrospectively analyzed the clinical data of 164 patients with pituitary adenomas admitted to Department of Neurosurgery, the 900 Hospital of Joint Logistics Team from March 2012 to March 2015. All patients underwent transsphenoidal approach to remove the tumor. The factors influencing hyponatremia were explored by univariate analysis and multivariate logistic regression analysis. Results Of 164 patients with pituitary adenomas, 10(6.1%) had hyponatremia before operation. Classical pituitary apoplexy occurred in 2 patients who had hyponatremia preoperatively. There were 37 cases of hyponatremia occurring after transsphenoidal surgery. Logistic multivariate analysis indicated that preoperative hypoadrenal axis dysfunction was a risk factor for preoperative hyponatremia (OR=6.738, 95%CI: 1.292-35.146, P=0.024), while preoperative hypothyroidism (OR=2.735, 95%CI: 1.149-6.511, P=0.023) was the predictive factor for postoperative hyponatremia. Conclusions The functions of adrenal gland axis and thyroid gland axis should be stressed when low blood sodium occurs in perioperative period in patients with pituitary adenomas. For patients with classical pituitary apoplexy, pituitary function and electrolyte levels should be closely monitored before surgery. Key words: Pituitary adenoma; Hyponatremia; Pituitary function; Risk factors