Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic Review
Introduction. Postoperative delayed hyponatremia is a complication associated with transsphenoidal pituitary surgery. Due to a wide spectrum of symptoms, the reported incidence and predictors of postoperative delayed hyponatremia vary among studies, and this deserves to be reviewed systematically. M...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2021/6659152 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832547749016371200 |
|---|---|
| author | Cheng-Chi Lee Yu-Chi Wang Yu-Tse Liu Yin-Cheng Huang Peng-Wei Hsu Kuo-Chen Wei Ko-Ting Chen Ya-Jui Lin Chi-Cheng Chuang |
| author_facet | Cheng-Chi Lee Yu-Chi Wang Yu-Tse Liu Yin-Cheng Huang Peng-Wei Hsu Kuo-Chen Wei Ko-Ting Chen Ya-Jui Lin Chi-Cheng Chuang |
| author_sort | Cheng-Chi Lee |
| collection | DOAJ |
| description | Introduction. Postoperative delayed hyponatremia is a complication associated with transsphenoidal pituitary surgery. Due to a wide spectrum of symptoms, the reported incidence and predictors of postoperative delayed hyponatremia vary among studies, and this deserves to be reviewed systematically. Methods. PubMed, EMBASE, and CENTRAL databases were searched until September 1, 2020. Studies were included when (1) the event number of delayed hyponatremia after transsphenoidal pituitary surgery was reported, or (2) the associated factors of such complication were evaluated. Results. A total of 27 studies were included for meta-analysis. The pooled incidence of overall and symptomatic delayed hyponatremia was 10.5% (95% confidence interval (CI) = 7.4–14.7%) and 5.0% (95% CI = 3.6–6.9%), respectively. No overt variations of the pooled estimates were observed upon subgroups stratified by endoscopic and microscopic procedure, publication year, and patients’ age. In addition, 44.3% (95% CI = 29.6–60.2%) of unplanned hospital readmissions within 30 days were caused by delayed hyponatremia. Among the predictors evaluated, older age was the only significant factor associated with increased delayed hyponatremia (odds ratio = 1.16, 95% CI = 1.04–1.29, P = 0.006). Conclusion. This meta-analysis and systematic review evaluated the incidence of postoperative delayed hyponatremia and found it as a major cause of unplanned readmissions after transsphenoidal pituitary surgery. Older patients are more prone to such complications and should be carefully followed. The retrospective nature and heterogeneity among the included studies and the small number of studies used for risk factor evaluation might weaken the corresponding results. Future prospective clinical studies are required to compensate for these limitations. |
| format | Article |
| id | doaj-art-f8aefb0be1204cb586bdf891d7cdc971 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-f8aefb0be1204cb586bdf891d7cdc9712025-02-03T06:43:33ZengWileyInternational Journal of Endocrinology1687-83371687-83452021-01-01202110.1155/2021/66591526659152Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic ReviewCheng-Chi Lee0Yu-Chi Wang1Yu-Tse Liu2Yin-Cheng Huang3Peng-Wei Hsu4Kuo-Chen Wei5Ko-Ting Chen6Ya-Jui Lin7Chi-Cheng Chuang8Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, TaiwanIntroduction. Postoperative delayed hyponatremia is a complication associated with transsphenoidal pituitary surgery. Due to a wide spectrum of symptoms, the reported incidence and predictors of postoperative delayed hyponatremia vary among studies, and this deserves to be reviewed systematically. Methods. PubMed, EMBASE, and CENTRAL databases were searched until September 1, 2020. Studies were included when (1) the event number of delayed hyponatremia after transsphenoidal pituitary surgery was reported, or (2) the associated factors of such complication were evaluated. Results. A total of 27 studies were included for meta-analysis. The pooled incidence of overall and symptomatic delayed hyponatremia was 10.5% (95% confidence interval (CI) = 7.4–14.7%) and 5.0% (95% CI = 3.6–6.9%), respectively. No overt variations of the pooled estimates were observed upon subgroups stratified by endoscopic and microscopic procedure, publication year, and patients’ age. In addition, 44.3% (95% CI = 29.6–60.2%) of unplanned hospital readmissions within 30 days were caused by delayed hyponatremia. Among the predictors evaluated, older age was the only significant factor associated with increased delayed hyponatremia (odds ratio = 1.16, 95% CI = 1.04–1.29, P = 0.006). Conclusion. This meta-analysis and systematic review evaluated the incidence of postoperative delayed hyponatremia and found it as a major cause of unplanned readmissions after transsphenoidal pituitary surgery. Older patients are more prone to such complications and should be carefully followed. The retrospective nature and heterogeneity among the included studies and the small number of studies used for risk factor evaluation might weaken the corresponding results. Future prospective clinical studies are required to compensate for these limitations.http://dx.doi.org/10.1155/2021/6659152 |
| spellingShingle | Cheng-Chi Lee Yu-Chi Wang Yu-Tse Liu Yin-Cheng Huang Peng-Wei Hsu Kuo-Chen Wei Ko-Ting Chen Ya-Jui Lin Chi-Cheng Chuang Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic Review International Journal of Endocrinology |
| title | Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic Review |
| title_full | Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic Review |
| title_fullStr | Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic Review |
| title_full_unstemmed | Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic Review |
| title_short | Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic Review |
| title_sort | incidence and factors associated with postoperative delayed hyponatremia after transsphenoidal pituitary surgery a meta analysis and systematic review |
| url | http://dx.doi.org/10.1155/2021/6659152 |
| work_keys_str_mv | AT chengchilee incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview AT yuchiwang incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview AT yutseliu incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview AT yinchenghuang incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview AT pengweihsu incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview AT kuochenwei incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview AT kotingchen incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview AT yajuilin incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview AT chichengchuang incidenceandfactorsassociatedwithpostoperativedelayedhyponatremiaaftertranssphenoidalpituitarysurgeryametaanalysisandsystematicreview |