Evidence map›Paper›PMID 34128213›Full record

ArticleJournal of endocrinological investigation2021

Diaphragma sellae sinking can predict the onset of hyponatremia after transsphenoidal surgery for pituitary adenomas.

Kunzhe Lin, Jun Li, Lingling Lu, Shangming Zhang, Shuwen Mu, Zhijie Pei, Cheng Wang, Jingying Lin, Liang Xue, Liangfeng Wei and 2 more

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Article in Journal of endocrinological investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Kunzhe Lin *Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China.
Jun Li *Department of Neurosurgery, 900th Hospital, Fuzhou, 350025, China.
Lingling LuFuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China.
Shangming ZhangDepartment of Neurosurgery, 900th Hospital, Fuzhou, 350025, China.
Shuwen MuFuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China.
Zhijie PeiFuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China.
Cheng WangFuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China.
Jingying LinFuzong Clinical Medical College, Fujian University Traditional Chinese Medicine, Fuzhou, 350122, China.
Liang XueDepartment of Neurosurgery, 900th Hospital, Fuzhou, 350025, China.
Liangfeng WeiDepartment of Neurosurgery, 900th Hospital, Fuzhou, 350025, China.
Lin ZhaoDepartment of Neurosurgery, 900th Hospital, Fuzhou, 350025, China.
Shousen WangFuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China. wshsen1965@126.com.

Funding

Innovation Joint Fund Project of Fujian Province 2019Y9045Leading Project of Fujian Province 2018Y0067
6 · The paper itself

Abstract

purposeSinking of the diaphragma sellae (DS) may stretch the pituitary stalk, which in turn impairs neurohypophyseal function; thus, it may play a role in the development of postoperative hyponatremia. We aimed to assess the factors influencing the development of hyponatremia after transsphenoidal surgery (TSS) for pituitary adenomas and analyze the effect of DS sinking on hyponatremia.

methodsAfter applying the inclusion and exclusion criteria, we retrospectively analyzed the clinical data of patients with pituitary adenoma who underwent TSS. The pituitary gland was scanned using a 3.0-T magnetic resonance imaging, and sagittal and coronal images were acquired. We evaluated the following: preoperative and postoperative hypothalamus‒pituitary‒thyroid axis function, hypothalamus‒pituitary‒adrenal axis function, intra-operative cerebrospinal fluid leaks, diabetes insipidus, hyponatremia, time from the day of surgery to the day of discharge, and time of hyponatremia onset.

resultsOf the 460 patients who had microscopic TSS for pituitary adenoma, 83 experienced postoperative hyponatremia. Hyponatremia occurred approximately 5.25 days postoperatively and persisted for 5.54 days. The lowest average blood sodium level was 123.9 mEq/L, which occurred at 7.49 days after surgery. Logistic regression analysis showed that the risk of hyponatremia was greater for patients with a significant DS sinking depth, a large pituitary stalk deviation angle difference, and a longer postoperative "measurable pituitary stalk". The difference in blood sodium levels between pre-TSS and 2 days post-TSS was also an independent predictor of postoperative hyponatremia onset.

conclusionDS sinking plays an important role in predicting hyponatremia onset after TSS for pituitary adenomas.

Indexed as

AdenomaCerebrospinal Fluid LeakDiabetes InsipidusHyponatremiaPituitary GlandPituitary NeoplasmsPostoperative ComplicationsFemaleHumansHypophysectomyIntraoperative ComplicationsMagnetic Resonance ImagingMaleMiddle AgedPrognosisRisk AssessmentSodiumDiaphragma sellaeHyponatremiaHypothalamo–hypophyseal systemPituitary adenoma

Identifiers

PMID34128213

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.