{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:51:07Z","timestamp":1785419467086,"version":"3.56.0"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The goal of this study was to characterize the pre-, peri-, and postoperative risk factors associated with early hyponatremia (defined as a serum sodium level &lt; 135 mEq\/L on or before postoperative day [POD] 3) following transsphenoidal pituitary surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective study was performed using a single-institution database for patients undergoing surgery for pituitary adenoma (PA). Serum values were collected routinely throughout the postoperative period. Uni- and multivariable statistical analyses were performed to identify independent predictors of early hyponatremia. Patients with diabetes insipidus receiving desmopressin were excluded from the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of 254 patients with nonfunctional PAs (NFPAs), 65 (25.6%) developed early-onset hyponatremia. Univariable analysis showed that older age, higher preoperative serum sodium, higher preoperative serum glucose, BMI &gt; 30 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and pituitary apoplexy were significantly associated with early hyponatremia (p &lt; 0.05). Multivariable logistic regression modeling revealed that the factors most strongly associated with early hyponatremia were thiazide diuretic use (OR 7.84, 95% CI 1.01\u201372.11; p = 0.049), pituitary apoplexy (OR 21.33, 95% CI 2.86\u2013271.37; p = 0.006), preoperative glucose level (OR 1.16 per 10 mg\/dl, 95% CI 1.02\u20131.36; p = 0.032), and BMI &gt; 27 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (OR 0.05, 95% CI 0.00\u20130.36; p = 0.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Early-onset hyponatremia is a common electrolyte derangement following transsphenoidal pituitary surgery for NFPAs. Clinical factors including low BMI, thiazide diuretic use, and elevated preoperative serum glucose were associated with an increased risk of early-onset hyponatremia. Higher BMI, in contrast, was protective against early-onset hyponatremia. Understanding the factors related to postoperative hyponatremia can aid in earlier detection, monitoring, and treatment for high-risk patients following PA surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.12.jns241384","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T21:54:07Z","timestamp":1744408447000},"page":"406-412","source":"Crossref","is-referenced-by-count":3,"title":["Predictive factors for early-onset hyponatremia following endoscopic transsphenoidal surgery for nonfunctioning pituitary adenomas"],"prefix":"10.3171","volume":"143","author":[{"given":"William","family":"Zeng","sequence":"first","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apurva","family":"Prasad","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amara","family":"Emeh","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda","family":"Perez","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Cote","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racheal","family":"Peterson","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishan","family":"Shah","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gomez","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Feng","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darryl","family":"Hwang","sequence":"additional","affiliation":[{"name":"Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Shiroishi","sequence":"additional","affiliation":[{"name":"Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Neurosurg","first-page":"1","article-title":"Predictors and rates of delayed symptomatic hyponatremia after transsphenoidal surgery: a systematic review","volume":"88","author":"Cote DJ","year":"2016","unstructured":"Cote DJ, Alzarea A, Acosta MA,  Predictors and rates of delayed symptomatic hyponatremia after transsphenoidal surgery: a systematic review. 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