Ki-67 and Preoperative Hypocortisolism are Predictive Factors for Postoperative Diabetes Insipidus After Endoscopic Pituitary Tumor Resection.

Abstract

Diabetes insipidus (DI) frequently occurs after surgery to remove pituitary tumors. It prolongs hospital stays, increases costs, and raises risks of other health issues. This study aims to identify risk factors for DI after pituitary tumor surgery to aid in early identification of high-risk patients. We studied 141 patients who had endoscopic pituitary tumor surgery from 2019 to 2023. Patients were grouped based on whether they developed DI postsurgery. We used statistical analyses to identify risk factors. Among the patients, 67 (47.5%) developed DI postsurgery, mostly transient. Factors like preoperative adrenal insufficiency (odds ratio 4.22, 95% confidence interval 1.15-15.51, P = 0.030) and Ki-67≥3% (odds ratio 3.04, 95% CI 1.17-7.85, P = 0.022) were found to independently increase DI risk. Patients with preoperative adrenal insufficiency or Ki-67≥3% are more likely to develop DI after surgery. Close monitoring of fluid balance is crucial post-surgery, and prompt use of desmopressin can help manage DI effectively.