{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:52:04Z","timestamp":1791417124794,"version":"4.3.3"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Delayed hyponatraemia(DH) is a common complication following trans-sphenoidal\n                    surgery(TSS) for pituitary tumour. We evaluated the prevalence of DH following\n                    TSS, and assessed the factors associated with DH, including early post-operative\n                    diabetes insipidus(EPDI). This retrospective study included 100 TSS for\n                    pituitary tumours in 98 patients, over a period of 26 months. Subjects were\n                    divided into two groups: those who developed hyponatraemia and those who did not\n                    develop hyponatraemia, during post-operative days 4 to 14. The clinical\n                    characteristics and peri-operative parameters were compared between the two\n                    groups, to identify factors predicting DH. The mean age of the patients was\n                    42.0\u00b113.6 years, 58 (59%) were females and 61 (61%) had\n                    functional tumours. Thirty-six patients(36%) developed DH following TSS\n                    of whom majority(58%) were diagnosed on post-operative days 7 and 8;\n                    only 8\/36 (22%) were symptomatic. Syndrome of inappropriate\n                    antidiuretic hormone secretion(SIADH) was found to be the most common aetiology\n                    of DH. On logistic regression analysis, intra-operative cerebrospinal fluid(CSF)\n                    leak (OR 5.0; 95% CI 1.9\u201313.8; p=0.002), EPDI (OR 3.4;\n                    95% CI 1.3\u20139.2; p=0.015) and peri-operative steroid use\n                    (OR 3.6; 95% CI 1.3\u20139.8; p=0.014) were found to be\n                    significantly associated with DH. In conclusion, EPDI, intra-operative CSF leak\n                    and peri-operative steroid use were significant predictors of DH. EPDI predicts\n                    moderate to severe hyponatraemia with 80% specificity but has low\n                    sensitivity(47%). As most patients have asymptomatic hyponatraemia,\n                    serum sodium measurement on POD 7 to 10 would be helpful to identify DH in\n                    patients at increased risk.<\/jats:p>","DOI":"10.1055\/a-2074-9329","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T22:30:25Z","timestamp":1686349825000},"page":"395-401","source":"Crossref","is-referenced-by-count":8,"title":["Predictors of Delayed Hyponatraemia After Surgery for Pituitary\n                    Tumour"],"prefix":"10.1055","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4136-9843","authenticated-orcid":false,"given":"Remya","family":"Rajan","sequence":"additional","affiliation":[{"name":"Endocrinology, Christian Medical College and Hospital Vellore, Vellore,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari George","family":"Chacko","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Christian Medical College and Hospital\n                    Vellore, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivendra","family":"Verma","sequence":"additional","affiliation":[{"name":"Endocrinology, GSVM Superspeciality Post Graduate Institute, Kanpur,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Endocrinology, Christian Medical College and Hospital Vellore, Vellore,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Paul","sequence":"additional","affiliation":[{"name":"Endocrinology, Christian Medical College and Hospital Vellore, Vellore,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihal","family":"Thomas","sequence":"additional","affiliation":[{"name":"Endocrinology, Christian Medical College and Hospital Vellore, Vellore,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Jebasingh","sequence":"additional","affiliation":[{"name":"Endocrinology, Christian Medical College and Hospital Vellore, Vellore,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kripa Elizabeth","family":"Cherian","sequence":"additional","affiliation":[{"name":"Endocrinology, Christian Medical College and Hospital Vellore, Vellore,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Sahu","sequence":"additional","affiliation":[{"name":"Radiology, Christian Medical College and Hospital Vellore, Vellore,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asha Hesarghatta","family":"Shyamasunder","sequence":"additional","affiliation":[{"name":"Endocrinology, Christian Medical College and Hospital Vellore, Vellore,\n                    India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.4103\/0028-3886.280637","article-title":"Delayed hyponatremia following surgery for pituitary adenomas: an\n                    under-recognized complication","volume":"68","author":"S Rajaratnam","year":"2020","journal-title":"Neurol India"},{"key":"ref2","first-page":"363","article-title":"Delayed hyponatremia after transsphenoidal surgery for pituitary adenoma","volume":"83","author":"D F Kelly","year":"1995","journal-title":"Report of nine cases. 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Chacko","year":"2020","journal-title":"Acta Neurochir (Wien)"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"E226","DOI":"10.1093\/neuros\/nyy479","article-title":"Withholding perioperative steroids in patients undergoing transsphenoidal\n                    resection for pituitary disease: randomized prospective clinical trial to assess\n                    safety","volume":"85","author":"K Sterl","year":"2019","journal-title":"Neurosurgery"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-13-1020","article-title":"Clinical practice guideline on diagnosis and treatment of hyponatraemia","volume":"170","author":"G Spasovski","year":"2014","journal-title":"Eur J Endocrinol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"42","DOI":"10.18773\/austprescr.2011.027","article-title":"Severe hyponatraemia \u2013 recognition and management","volume":"34","author":"G Shannon","year":"2011","journal-title":"Aust 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mechanisms of water and electrolyte disturbances after\n                    transsphenoidal pituitary surgery","volume":"107","author":"E T Blair","year":"2017","journal-title":"World Neurosurg"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2074-9329.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T22:31:01Z","timestamp":1686349861000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2074-9329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":23,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2023,6,9]]},"published-print":{"date-parts":[[2023,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2074-9329","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}