{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:25:56Z","timestamp":1794014756713,"version":"4.8.0"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common problem during the postoperative course after pituitary surgery. Although treatment of this condition is well characterized, prevention strategies are less studied and reported. The authors sought to characterize outcomes and predictive factors of SIADH after implementation of routine postoperative fluid restriction for patients undergoing endoscopic transsphenoidal surgery for pituitary adenoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In March 2018, routine postoperative fluid restriction to 1000 ml\/day for 7 days was instituted for all patients who underwent surgery for pituitary adenoma. These patients were compared with patients who underwent surgery for pituitary adenoma between March 2016 and March 2018, prior to implementation of routine fluid restriction. Patients with preoperative history of diabetes insipidus (DI) or concern for postsurgical DI were excluded. Patients were followed by neuroendocrinologists and neurosurgeons, and sodium levels were checked between 7 and 10 days postoperatively. SIADH was defined by a serum sodium level less than 136 mmol\/L, with or without symptoms within 10 days after surgery. Thirty-day readmission was recorded and reviewed to determine underlying reasons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In total, 82 patients in the fluid-unrestricted cohort and 135 patients in the fluid-restricted cohort were analyzed. The patients in the fluid-restricted cohort had a significantly lower rate of postoperative SIADH than patients in the fluid-unrestricted cohort (5% vs 15%, adjusted OR [95% CI] 0.1 [0.0\u20130.6], p = 0.01). Higher BMI was associated with lower rate of postoperative SIADH (adjusted OR [95%] 0.9 [0.9\u20131.0], p = 0.03), whereas female sex was associated with higher rate of SIADH (adjusted OR [95% CI] 3.1 [1.1\u20139.8], p = 0.03). There was no difference in the 30-day readmission rates between patients in the fluid-unrestricted and fluid-restricted cohorts (4% vs 7%, adjusted OR [95% CI] 0.5 [0\u20135.1], p = 0.56). Thirty-day readmission was more likely for patients with history of hypertension (adjusted OR [95% CI] 5.7 [1.3\u201326.3], p = 0.02) and less likely for White patients (adjusted OR [95% CI] 0.3 [0.1\u20130.9], p = 0.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Routine fluid restriction reduced the rate of SIADH in patients who underwent surgery for pituitary adenoma but was not associated with reduction in 30-day readmission rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.1.jns203579","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T14:39:22Z","timestamp":1629729562000},"page":"405-412","source":"Crossref","is-referenced-by-count":20,"title":["Routine postoperative fluid restriction to prevent syndrome of inappropriate antidiuretic hormone secretion after transsphenoidal resection of pituitary adenoma"],"prefix":"10.3171","volume":"136","author":[{"given":"M. Harrison","family":"Snyder","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Asuzu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and"},{"name":"Surgical Neurology Branch, National Institute of Neurologic Disorders and Stroke, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn E.","family":"Shaver","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Lee","family":"Vance","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Jane","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Clin Med","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.3390\/jcm3041199","article-title":"Incidence, etiology and outcomes of hyponatremia after transsphenoidal surgery: experience with 344 consecutive patients at a single tertiary center","volume":"3","author":"Barber SM","year":"2014","unstructured":"Barber SM, Liebelt BD, Baskin DS. Incidence, etiology and outcomes of hyponatremia after transsphenoidal surgery: experience with 344 consecutive patients at a single tertiary center. J Clin Med. 2014;3(4):1199\u20131219.10.3390\/jcm3041199"},{"issue":"4","key":"b2","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/j.nec.2019.05.011","article-title":"Sodium perturbations after pituitary surgery","volume":"30","author":"Yuen KCJ","year":"2019","unstructured":"Yuen KCJ, Ajmal A, Correa R, Little AS. Sodium perturbations after pituitary surgery. Neurosurg Clin N Am. 2019;30(4):515\u2013524.10.1016\/j.nec.2019.05.01131471059"},{"key":"b3","series-title":"Transnasal Endoscopic Skull Base and Brain Surgery","article-title":"Chapter 46: Endocrine complications after endoscopic skull base surgery","author":"Bush Z","unstructured":"Bush Z, Vance ML, Jane JA Jr. Chapter 46: Endocrine complications after endoscopic skull base surgery. In: Stamm AC, ed.Transnasal Endoscopic Skull Base and Brain Surgery.1st ed. Thieme; 2011:448."},{"issue":"6","key":"b4","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1478","DOI":"10.3171\/2013.7.JNS13273","article-title":"Factors predicting postoperative hyponatremia and efficacy of hyponatremia management strategies after more than 1000 pituitary operations","volume":"119","author":"Jahangiri A","year":"2013","unstructured":"Jahangiri A, Wagner J, Tran MT,  Factors predicting postoperative hyponatremia and efficacy of hyponatremia management strategies after more than 1000 pituitary operations. J Neurosurg. 2013;119(6):1478\u20131483.2397196410.3171\/2013.7.JNS13273"},{"issue":"3","key":"b5","series-title":"J Intensive Care Med","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1177\/0885066605275247","article-title":"Postoperative care following pituitary surgery","volume":"20","author":"Dumont AS","year":"2005","unstructured":"Dumont AS, Nemergut EC II, Jane JA Jr, Laws ER Jr. Postoperative care following pituitary surgery. J Intensive Care Med. 2005;20(3):127\u2013140.1588890010.1177\/0885066605275247"},{"issue":"1","key":"b6","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s11102-017-0843-5","article-title":"A practical method for prevention of readmission for symptomatic hyponatremia following transsphenoidal surgery","volume":"21","author":"Burke WT","year":"2018","unstructured":"Burke WT, Cote DJ, Iuliano SI,  A practical method for prevention of readmission for symptomatic hyponatremia following transsphenoidal surgery. Pituitary. 2018;21(1):25\u201331.10.1007\/s11102-017-0843-529075986"},{"issue":"2","key":"b7","series-title":"Endocrine","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s12020-018-1656-7","article-title":"Strategies to reduce readmissions for hyponatremia after transsphenoidal surgery for pituitary adenomas","volume":"62","author":"Deaver KE","year":"2018","unstructured":"Deaver KE, Catel CP, Lillehei KO,  Strategies to reduce readmissions for hyponatremia after transsphenoidal surgery for pituitary adenomas. Endocrine. 2018;62(2):333\u2013339.2996119810.1007\/s12020-018-1656-7"},{"issue":"6","key":"b8","series-title":"Eur J Endocrinol","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1530\/EJE-14-0530","article-title":"Early water intake restriction to prevent inappropriate antidiuretic hormone secretion following transsphenoidal surgery: low BMI predicts postoperative SIADH","volume":"171","author":"Matsuyama J","year":"2014","unstructured":"Matsuyama J, Ikeda H, Sato S,  Early water intake restriction to prevent inappropriate antidiuretic hormone secretion following transsphenoidal surgery: low BMI predicts postoperative SIADH. Eur J Endocrinol. 2014;171(6):711\u2013716.2522713210.1530\/EJE-14-0530"},{"issue":"1-2","key":"b9","series-title":"Biometrika","first-page":"28","article-title":"The generalisation of student\u2019s problems when several different population variances are involved","volume":"34","author":"Welch BL","year":"1947","unstructured":"Welch BL. The generalisation of student\u2019s problems when several different population variances are involved. Biometrika. 1947;34(1-2):28\u201335.20287819"},{"issue":"2","key":"b10","series-title":"Am J Kidney Dis","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1053\/j.ajkd.2019.07.014","article-title":"Diagnosis and management of disorders of body tonicity-hyponatremia and hypernatremia: core curriculum 2020","volume":"75","author":"Seay NW","year":"2020","unstructured":"Seay NW, Lehrich RW, Greenberg A. Diagnosis and management of disorders of body tonicity-hyponatremia and hypernatremia: core curriculum 2020. Am J Kidney Dis. 2020;75(2):272\u2013286.10.1053\/j.ajkd.2019.07.01431606238"},{"issue":"4","key":"b11","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"499","DOI":"10.3171\/jns.1997.87.4.0499","article-title":"Pathophysiology of hyponatremia after transsphenoidal pituitary surgery","volume":"87","author":"Olson BR","year":"1997","unstructured":"Olson BR, Gumowski J, Rubino D, Oldfield EH. Pathophysiology of hyponatremia after transsphenoidal pituitary surgery. J Neurosurg. 1997;87(4):499\u2013507.932283910.3171\/jns.1997.87.4.0499"},{"issue":"2","key":"b12","series-title":"Best Pract Res Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.beem.2016.02.009","article-title":"The syndrome of inappropriate antidiuresis (SIAD)","volume":"30","author":"Cuesta M","year":"2016","unstructured":"Cuesta M, Thompson CJ. The syndrome of inappropriate antidiuresis (SIAD). Best Pract Res Clin Endocrinol Metab. 2016;30(2):175\u2013187.10.1016\/j.beem.2016.02.00927156757"},{"issue":"9-10","key":"b13","series-title":"Acta Oncol","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.3109\/0284186X.2016.1170198","article-title":"Malignancy associated SIADH: characterization and clinical implications","volume":"55","author":"Goldvaser H","year":"2016","unstructured":"Goldvaser H, Rozen-Zvi B, Yerushalmi R,  Malignancy associated SIADH: characterization and clinical implications. Acta Oncol. 2016;55(9-10):1190\u20131195.2714229310.3109\/0284186X.2016.1170198"},{"issue":"1","key":"b14","series-title":"Am J Kidney Dis","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1053\/j.ajkd.2008.03.004","article-title":"A review of drug-induced hyponatremia","volume":"52","author":"Liamis G","year":"2008","unstructured":"Liamis G, Milionis H, Elisaf M. A review of drug-induced hyponatremia. Am J Kidney Dis. 2008;52(1):144\u2013153.10.1053\/j.ajkd.2008.03.00418468754"},{"issue":"8","key":"b15","series-title":"Br J Clin Pharmacol","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1111\/bcp.13256","article-title":"Medication-induced SIADH: distribution and characterization according to medication class","volume":"83","author":"Shepshelovich D","year":"2017","unstructured":"Shepshelovich D, Schechter A, Calvarysky B,  Medication-induced SIADH: distribution and characterization according to medication class. Br J Clin Pharmacol. 2017;83(8):1801\u20131807.10.1111\/bcp.1325628168757"},{"issue":"6","key":"b16","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.3171\/2013.8.JNS13411","article-title":"Delayed postoperative hyponatremia after transsphenoidal surgery: prevalence and associated factors","volume":"119","author":"Hussain NS","year":"2013","unstructured":"Hussain NS, Piper M, Ludlam WG,  Delayed postoperative hyponatremia after transsphenoidal surgery: prevalence and associated factors. J Neurosurg. 2013;119(6):1453\u20131460.2405349610.3171\/2013.8.JNS13411"},{"issue":"5","key":"b17","series-title":"Endocr J","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1507\/endocrj.K10E-352","article-title":"Post-operative hyponatremia in patients with pituitary adenoma: post-operative management with a uniform treatment protocol","volume":"58","author":"Kinoshita Y","year":"2011","unstructured":"Kinoshita Y, Tominaga A, Arita K,  Post-operative hyponatremia in patients with pituitary adenoma: post-operative management with a uniform treatment protocol. Endocr J. 2011;58(5):373\u2013379.10.1507\/endocrj.K10E-35221467692"},{"issue":"1","key":"b18","series-title":"J Clin Endocrinol Metab","first-page":"85","article-title":"Isolated hyponatremia after transsphenoidal pituitary surgery","volume":"80","author":"Olson BR","year":"1995","unstructured":"Olson BR, Rubino D, Gumowski J, Oldfield EH. Isolated hyponatremia after transsphenoidal pituitary surgery. J Clin Endocrinol Metab. 1995;80(1):85\u201391.7829644"},{"issue":"5","key":"b19","series-title":"J Clin Endocrinol Metab","first-page":"1395","article-title":"Hyponatremia after transsphenoidal surgery for pituitary tumors","volume":"79","author":"Sane T","year":"1994","unstructured":"Sane T, Rantakari K, Poranen A,  Hyponatremia after transsphenoidal surgery for pituitary tumors. J Clin Endocrinol Metab. 1994;79(5):1395\u20131398.7962334"},{"issue":"1","key":"b20","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"66","DOI":"10.3171\/jns.2007.106.1.66","article-title":"Recognition and management of delayed hyponatremia following transsphenoidal pituitary surgery","volume":"106","author":"Zada G","year":"2007","unstructured":"Zada G, Liu CY, Fishback D,  Recognition and management of delayed hyponatremia following transsphenoidal pituitary surgery. J Neurosurg. 2007;106(1):66\u201371.10.3171\/jns.2007.106.1.6617236489"},{"issue":"5","key":"b21","series-title":"Semin Perinatol","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1053\/j.semperi.2017.04.008","article-title":"Exploring the social determinants of racial\/ethnic disparities in prenatal care utilization and maternal outcome","volume":"41","author":"Gadson A","year":"2017","unstructured":"Gadson A, Akpovi E, Mehta PK. Exploring the social determinants of racial\/ethnic disparities in prenatal care utilization and maternal outcome. Semin Perinatol. 2017;41(5):308\u2013317.10.1053\/j.semperi.2017.04.00828625554"},{"issue":"2","key":"b22","series-title":"Clin Nephrol","doi-asserted-by":"publisher","first-page":"75","DOI":"10.5414\/CN108453","article-title":"Hyponatremia: incidence, risk factors, and consequences in the elderly in a home-based primary care program","volume":"84","author":"Ganguli A","year":"2015","unstructured":"Ganguli A, Mascarenhas RC, Jamshed N,  Hyponatremia: incidence, risk factors, and consequences in the elderly in a home-based primary care program. Clin Nephrol. 2015;84(2):75\u201385.10.5414\/CN108453"},{"issue":"4","key":"b23","series-title":"Ann Surg Oncol","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1245\/s10434-012-2837-x","article-title":"Association of race and socioeconomic status and outcomes of patients with rectal cancer","volume":"20","author":"Nitzkorski JR","year":"2013","unstructured":"Nitzkorski JR, Willis AI, Nick D,  Association of race and socioeconomic status and outcomes of patients with rectal cancer. Ann Surg Oncol. 2013;20(4):1142\u20131147.2333425210.1245\/s10434-012-2837-x"},{"issue":"4","key":"b24","series-title":"Am J Med Sci","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.amjms.2016.01.008","article-title":"Influence of race, ethnicity and social determinants of health on diabetes outcomes","volume":"351","author":"Walker RJ","year":"2016","unstructured":"Walker RJ, Strom Williams J, Egede LE. Influence of race, ethnicity and social determinants of health on diabetes outcomes. Am J Med Sci. 2016;351(4):366\u2013373.10.1016\/j.amjms.2016.01.00827079342"},{"issue":"18","key":"b25","series-title":"J Am Heart Assoc","doi-asserted-by":"publisher","first-page":"e009863","DOI":"10.1161\/JAHA.118.009863","article-title":"Thirty-day readmission rates, timing, causes, and costs after ST-segment-elevation myocardial infarction in the United States: a National Readmission Database Analysis 2010\u20132014","volume":"7","author":"Kim LK","year":"2018","unstructured":"Kim LK, Yeo I, Cheung JW,  Thirty-day readmission rates, timing, causes, and costs after ST-segment-elevation myocardial infarction in the United States: a National Readmission Database Analysis 2010\u20132014. J Am Heart Assoc. 2018;7(18):e009863.3037118710.1161\/JAHA.118.009863"},{"issue":"3","key":"b26","series-title":"J Vasc Surg","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1016\/j.jvs.2019.01.079","article-title":"A systematic review and meta-analysis of risk factors for and incidence of 30-day readmission after revascularization for peripheral artery disease","volume":"70","author":"Smith SL","year":"2019","unstructured":"Smith SL, Matthews EO, Moxon JV, Golledge J. A systematic review and meta-analysis of risk factors for and incidence of 30-day readmission after revascularization for peripheral artery disease. J Vasc Surg. 2019;70(3):996\u20131006.e7.10.1016\/j.jvs.2019.01.07931445653"},{"issue":"1","key":"b27","series-title":"J Renin Angiotensin Aldosterone Syst","doi-asserted-by":"publisher","first-page":"1470320319834409","DOI":"10.1177\/1470320319834409","article-title":"Syndrome of inappropriate secretion of antidiuretic hormone associated with angiotensin-converting enzyme inhibitor therapy in the perioperative period","volume":"20","author":"Nakayama T","year":"2019","unstructured":"Nakayama T, Fujisaki H, Hirai S,  Syndrome of inappropriate secretion of antidiuretic hormone associated with angiotensin-converting enzyme inhibitor therapy in the perioperative period. J Renin Angiotensin Aldosterone Syst. 2019;20(1):1470320319834409.3084345810.1177\/1470320319834409"},{"issue":"1-2","key":"b28","series-title":"Nagoya J Med Sci","first-page":"73","article-title":"A novel method for managing water and electrolyte balance after transsphenoidal surgery: preliminary study of moderate water intake restriction","volume":"76","author":"Takeuchi K","year":"2014","unstructured":"Takeuchi K, Nagatani T, Okumura E, Wakabayashi T. A novel method for managing water and electrolyte balance after transsphenoidal surgery: preliminary study of moderate water intake restriction. Nagoya J Med Sci. 2014;76(1-2):73\u201382.25129993"},{"issue":"2","key":"b29","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"363","DOI":"10.3171\/jns.1995.83.2.0363","article-title":"Delayed hyponatremia after transsphenoidal surgery for pituitary adenoma. Report of nine cases","volume":"83","author":"Kelly DF","year":"1995","unstructured":"Kelly DF, Laws ER Jr, Fossett D. Delayed hyponatremia after transsphenoidal surgery for pituitary adenoma. Report of nine cases. J Neurosurg. 1995;83(2):363\u2013367.761628710.3171\/jns.1995.83.2.0363"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/136\/2\/article-p405.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/136\/2\/article-p405.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/136\/2\/article-p405.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:07:09Z","timestamp":1794013629000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/136\/2\/article-p405.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,1]]},"references-count":29,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2021.1.jns203579","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,1]]}}}