Evidence map›Paper›PMID 37525288›Full record

ArticleChinese neurosurgical journal2023

Predictors and dynamic online nomogram for postoperative delayed hyponatremia after endoscopic transsphenoidal surgery for pituitary adenomas: a single-center, retrospective, observational cohort study with external validation.

Xiangming Cai, An Zhang, Peng Zhao, Zhiyuan Liu, Yiliyaer Aili, Xinrui Zeng, Yuanming Geng, Chaonan Du, Feng Yuan, Junhao Zhu and 5 more

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In one paragraph

Article in Chinese neurosurgical journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Xiangming Cai *Department of Neurosurgery, Jinling Hospital, Nanjing, China.
An Zhang *Department of Neurosurgery, Jinling Hospital, Nanjing, China.
Peng Zhao *Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Zhiyuan LiuDepartment of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Yiliyaer AiliDepartment of Neurosurgery, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing, China.
Xinrui ZengSchool of Medicine, Southeast University, Nanjing, China.
Yuanming GengDepartment of Neurosurgery, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing, China.
Chaonan DuDepartment of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Feng YuanDepartment of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Junhao ZhuDepartment of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Jin YangDepartment of Neurosurgery, Jinling Hospital, Nanjing, China.
Chao TangDepartment of Neurosurgery, Jinling Hospital, Nanjing, China.
Zixiang CongDepartment of Neurosurgery, Jinling Hospital, Nanjing, China.
Yuxiu LiuDepartment of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, China. liu_yuxiu@163.com.
Chiyuan MaDepartment of Neurosurgery, Jinling Hospital, Nanjing, China. machiyuan_nju@126.com.ORCID http://orcid.org/0000-0002-1710-5955

Funding

China Scholarship Council 202206090022Jiangsu Provincial Department of Science and Technology of China BE2022821
6 · The paper itself

Abstract

backgroundPostoperative delayed hyponatremia (PDH) is a major cause of readmission after endoscopic transsphenoidal surgery (eTSS) for pituitary adenomas (PAs). However, the risk factors associated with PDH have not been well established, and the development of a dynamic online nomogram for predicting PDH is yet to be realized. We aimed to investigate the predictive factors for PDH and construct a dynamic online nomogram to aid in its prediction.

methodsWe analyzed the data of 226 consecutive patients who underwent eTSS for PAs at the Department of Neurosurgery in Jinling Hospital between January 2018 and October 2020. An additional 97 external patients were included for external validation. PDH was defined as a serum sodium level below 137 mmol/L, occurring on the third postoperative day (POD) or later.

resultsHyponatremia on POD 1-2 (OR = 2.64, P = 0.033), prothrombin time (PT) (OR = 1.78, P = 0.008), and percentage of monocytes (OR = 1.22, P = 0.047) were identified as predictive factors for PDH via multivariable logistic regression analysis. Based on these predictors, a nomogram was constructed with great discrimination in internal validation (adjusted AUC: 0.613-0.688) and external validation (AUC: 0.594-0.617). Furthermore, the nomogram demonstrated good performance in calibration plot, Brier Score, and decision curve analysis. Subgroup analysis revealed robust predictive performance in patients with various clinical subtypes and mild to moderate PDH.

conclusionsPreoperative PT and the percentage of monocytes were, for the first time, identified as predictive factors for PDH. The dynamic nomogram proved to be a valuable tool for predicting PDH after eTSS for PAs and demonstrated good generalizability. Patients could benefit from early identification of PDH and optimized treatment decisions.

Indexed as

Endoscopic transsphenoidal surgeryNomogramPituitary adenomasPostoperative delayed hyponatremiaPredictors

Identifiers

PMID37525288
PMCPMC10391999

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