ArticlePituitary2021
Diabetes insipidus after endoscopic transsphenoidal surgery: multicenter experience and development of the SALT score.
Article in Pituitary, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Pooled it
- Social Determinants of Health in Endoscopic Anterior Skull Base Surgery: A Systematic Review and Meta-Analysis.Laryngoscope investigative otolaryngology · 2025Review
- Exploring factors behind Arginine-Vasopressine deficiency in endoscopic endonasal surgery for PitNET: a single-center analysis of 349 patients.Neurosurgical review · 2025Article
- Extended endoscopic endonasal approach for solid or predominantly solid third ventricle craniopharyngiomas complicated with obstructive hydrocephalus: a single-center experience of 27 patients.Neurosurgical review · 2025Article
- Risk Factors for Development of Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone Secretion after Transsphenoidal Resection of Pituitary Adenoma.Journal of neurological surgery. Part B, Skull base · 2025Article
- Article
- Severe hypernatremia during postoperative care in patients with craniopharyngioma.Endocrine connections · 2023Article
- Article
- Glucocorticoids and Water Balance: Implications for Hyponatremia Management and Pituitary Surgery.Neuroendocrinology · 2023Review
- Predictors of visual and endocrine outcomes after endoscopic transsphenoidal surgery for pituitary adenomas.Neurosurgical review · 2022Article
- Masked diabetes insipidus in pituitary metastasis from breast cancer after thalamic biopsy: a case report.Journal of medical case reports · 2022Article
- Predicting the Need for Desmopressin Treatment During Inpatient and After Discharge Following Endoscopic Sellar Surgery.Frontiers in neurology · 2022Article
- Frailty does not preclude surgical success after endoscopic transsphenoidal surgery for pituitary adenomas.Pituitary · 2021Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify risk factors for the development of postoperative diabetes insipidus (DI) in a modern cohort of endoscopic endonasal transsphenoidal surgery.
methodsAnalysis of prospectively collected data of 449 consecutive patients operated on for anterior skull base pathology. DI was defined as a polyuria (> 250 ml/h for ≥ 2 consecutive hours) polydipsia syndrome associated with hypotonic urine with or without hypernatraemia. Multivariate logistic regression was used to identify predictors of postoperative DI. A simple scoring system was then created.
resultsPostoperative DI occurred in 46 (10.2%) patients. The development of DI did not affect quality of life. Predictors of DI on multivariate analysis included suprasellar extension (OR 2.2; p = 0.04), age < 50 years (OR 2.8; p = 0.003), craniopharyngioma histology (OR 6.7; p = 0.002), and Kelly grade 3 intraoperative CSF leak (OR 2.1; p = 0.04). The SALT score was created based on these characteristics, with one point awarded for each feature present, and predicted DI with fair to good predictive value in our cohort (AUROC 0.735 (95%CI 0.65-0.82)). The rates of postoperative DI were 4.0%, 6.5%, 15.0%. 36.8% and 85.7% for SALT scores of zero, one, two, three, and four, respectively.
conclusionsThe SALT score predicts postoperative DI with fair to good accuracy, and now requires prospective external validation. Improved prediction of DI could optimize resource allocation and facilitate individualised preoperative patient counselling. We also provide our algorithm for diagnosis and treatment of DI.
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