{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T10:24:50Z","timestamp":1794219890727,"version":"4.8.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Secondary adrenal insufficiency (SAI) is an uncommon sequela following resection of pituitary adenoma. The aim of this study was to evaluate the utility of postoperative days (PODs) 1 and 2 morning cortisol levels for predicting the development of new SAI and other endocrine outcomes following pituitary adenoma resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients who underwent resection of pituitary adenoma (June 2012\u2013August 2023) with available POD1 or POD2 morning serum cortisol levels and a minimum postoperative endocrine follow-up of 1 year were included. Patients were excluded if they had preexisting Cushing\u2019s syndrome or received steroids perioperatively. Logistic regression and receiver operating characteristic analyses were conducted to assess the performance of POD1 and POD2 morning cortisol levels for prediction of new postoperative SAI and other long-term endocrine outcomes, with optimal cutoff values determined using Youden\u2019s index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 229 patients (137 female, mean age 51.4 years), 219 (95.6%) had available POD1 morning cortisol results, 59 (25.7%) had POD2 results, and 49 (21.4%) had both POD1 and POD2 results. Eighteen patients (7.8%) developed new SAI postoperatively. Over long-term follow-up, 6.1% of patients had long-term SAI, 24.8% had persistent new hypopituitarism in one or more pituitary axes, 17.0% had new hypogonadotropic hypogonadism, 13.0% had new central hypothyroidism, 3.9% had arginine vasopressin deficiency, and 3.0% had growth hormone deficiency. The development of any SAI was significantly associated with both POD1 (OR 0.91, 95% CI 0.86\u20130.97; p = 0.004) and POD2 (OR 0.30, 95% CI 0.09\u20130.96; p = 0.041) morning cortisol levels, with POD2 levels having superior discriminative performance (POD1: area under the receiver operating characteristic curve [AUC] 0.719 vs POD2: AUC 0.990). POD2 morning cortisol significantly predicted development of any SAI (AUC 0.990, p &lt; 0.001) with a cutoff of 4.95 \u00b5g\/dL (sensitivity of 100% and specificity of 96.1%). Logistic regression revealed that each 1-\u00b5g\/dL increase in POD1 morning cortisol was associated with reduced odds of developing any SAI by 9% (OR 0.91, 95% CI 0.86\u20130.97; p = 0.004). In those who underwent POD2 cortisol testing, each 1-\u00b5g\/dL increase in the POD2 morning cortisol level was associated with reduced odds of developing any SAI by 70% (OR 0.30, 95% CI 0.09\u20130.96; p = 0.041).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Although cortisol assessment on both POD1 and POD2 was useful following pituitary adenoma resection, the POD2 morning cortisol level was a more specific predictor of new postoperative SAI while also having predictive utility for other long-term endocrinopathies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.9.jns251261","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T01:47:56Z","timestamp":1770428876000},"page":"59-67","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative days 1 and 2 morning cortisol levels as predictors of long-term secondary adrenal insufficiency following pituitary adenoma surgery"],"prefix":"10.3171","volume":"145","author":[{"given":"Kevin G.","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishan","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Cote","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"},{"name":"Department of Medicine, Division of Endocrinology and Diabetes, Keck School of Medicine at The University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine at The University of Southern California, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Endocrinol Metab Clin North Am","first-page":"347","article-title":"The epidemiology of pituitary adenomas","volume":"49","author":"Daly AF","year":"2020","unstructured":"Daly AF, Beckers A. The epidemiology of pituitary adenomas. Endocrinol Metab Clin North Am. 2020;49(3):347\u2013355."},{"issue":"4","key":"b2","series-title":"Acta Neurochir (Wien)","first-page":"845","article-title":"Cut-off values for sufficient cortisol response to low dose Short Synacthen Test after surgery for non-functioning pituitary adenoma","volume":"162","author":"Kolnes AJ","year":"2020","unstructured":"Kolnes AJ, \u00d8ystese KA, Dahlberg D,  Cut-off values for sufficient cortisol response to low dose Short Synacthen Test after surgery for non-functioning pituitary adenoma. Acta Neurochir (Wien). 2020;162(4):845\u2013852."},{"issue":"11","key":"b3","series-title":"Endocr J","first-page":"965","article-title":"Relationship of each anterior pituitary hormone deficiency to the size of non-functioning pituitary adenoma in the hospitalized patients","volume":"63","author":"Mukai K","year":"2016","unstructured":"Mukai K, Kitamura T, Tamada D, Murata M, Otsuki M, Shimomura I. Relationship of each anterior pituitary hormone deficiency to the size of non-functioning pituitary adenoma in the hospitalized patients. Endocr J. 2016;63(11):965\u2013976."},{"key":"b4","series-title":"World Neurosurg","first-page":"e275","article-title":"Characteristics of nonfunctioning pituitary adenomas that cause secondary adrenal insufficiency","volume":"153","author":"Oshino S","year":"2021","unstructured":"Oshino S, Saitoh Y, Kinoshita M, Mukai K, Otsuki M, Kishima H. Characteristics of nonfunctioning pituitary adenomas that cause secondary adrenal insufficiency. World Neurosurg. 2021;153:e275\u2013e281."},{"issue":"1","key":"b5","series-title":"Neurosurg Rev","first-page":"843","article-title":"Predictors of visual and endocrine outcomes after endoscopic transsphenoidal surgery for pituitary adenomas","volume":"45","author":"Castle-Kirszbaum M","year":"2022","unstructured":"Castle-Kirszbaum M, Wang YY, King J, Goldschlager T. Predictors of visual and endocrine outcomes after endoscopic transsphenoidal surgery for pituitary adenomas. Neurosurg Rev. 2022;45(1):843\u2013853."},{"issue":"4","key":"b6","series-title":"Neurosurg Clin N Am","first-page":"491","article-title":"Endocrine outcomes after pituitary surgery","volume":"30","author":"Buttan A","year":"2019","unstructured":"Buttan A, Mamelak AN. Endocrine outcomes after pituitary surgery. Neurosurg Clin N Am. 2019;30(4):491\u2013498."},{"issue":"1","key":"b7","series-title":"Neurosurgery","first-page":"42","article-title":"Long-term results of endonasal endoscopic transsphenoidal resection of nonfunctioning pituitary macroadenomas","volume":"76","author":"Dallapiazza RF","year":"2015","unstructured":"Dallapiazza RF, Grober Y, Starke RM, Laws ER Jr, Jane JA Jr. Long-term results of endonasal endoscopic transsphenoidal resection of nonfunctioning pituitary macroadenomas. Neurosurgery. 2015;76(1):42\u201353."},{"issue":"2","key":"b8","series-title":"Br J Anaesth","first-page":"e41","article-title":"Prophylactic steroid administration and complications after transsphenoidal pituitary surgery: a nationwide inpatient database study in Japan","volume":"127","author":"Hattori Y","year":"2021","unstructured":"Hattori Y, Tahara S, Aso S,  Prophylactic steroid administration and complications after transsphenoidal pituitary surgery: a nationwide inpatient database study in Japan. Br J Anaesth. 2021;127(2):e41\u2013e43."},{"issue":"11","key":"b9","series-title":"JAMA Netw Open","first-page":"e2242221","article-title":"Safety of withholding perioperative hydrocortisone for patients with pituitary adenomas with an intact hypothalamus-pituitary-adrenal axis: a randomized clinical trial","volume":"5","author":"Guo X","year":"2022","unstructured":"Guo X, Zhang D, Pang H,  Safety of withholding perioperative hydrocortisone for patients with pituitary adenomas with an intact hypothalamus-pituitary-adrenal axis: a randomized clinical trial. JAMA Netw Open. 2022;5(11):e2242221."},{"issue":"2","key":"b10","series-title":"Pituitary","first-page":"160","article-title":"Prediction of adrenal insufficiency after pituitary surgery: a retrospective study using beckman access cortisol assay","volume":"27","author":"Birtolo MF","year":"2024","unstructured":"Birtolo MF, Giannini E, Antonini S,  Prediction of adrenal insufficiency after pituitary surgery: a retrospective study using beckman access cortisol assay. Pituitary. 2024;27(2):160\u2013168."},{"issue":"3","key":"b11","series-title":"Clin Med (Lond)","first-page":"258","article-title":"Adrenal insufficiency - recognition and management","volume":"17","author":"Pazderska A","year":"2017","unstructured":"Pazderska A, Pearce SH. Adrenal insufficiency - recognition and management. Clin Med (Lond). 2017;17(3):258\u2013262."},{"issue":"4","key":"b12","series-title":"Clin Invest Med","first-page":"E216","article-title":"The role of morning basal serum cortisol in assessment of hypothalamic pituitary-adrenal axis","volume":"36","author":"Yip CE","year":"2013","unstructured":"Yip CE, Stewart SA, Imran F,  The role of morning basal serum cortisol in assessment of hypothalamic pituitary-adrenal axis. Clin Invest Med. 2013;36(4):E216\u2013E222."},{"issue":"5","key":"b13","series-title":"Clin Chem","first-page":"972","article-title":"Day 5 morning serum cortisol predicts hypothalamic-pituitary-adrenal function after transsphenoidal surgery for pituitary tumors","volume":"55","author":"Jayasena CN","year":"2009","unstructured":"Jayasena CN, Gadhvi KA, Gohel B,  Day 5 morning serum cortisol predicts hypothalamic-pituitary-adrenal function after transsphenoidal surgery for pituitary tumors. Clin Chem. 2009;55(5):972\u2013977."},{"issue":"4","key":"b14","series-title":"Endocr Pract","first-page":"686","article-title":"Diagnostic predicament of secondary adrenal insufficiency","volume":"16","author":"Santhanam P","year":"2010","unstructured":"Santhanam P, Saleem SF, Saleem TF. Diagnostic predicament of secondary adrenal insufficiency. Endocr Pract. 2010;16(4):686\u2013691."},{"issue":"5","key":"b15","series-title":"Clin Endocrinol (Oxf)","first-page":"603","article-title":"The overnight single-dose metyrapone test is a simple and reliable index of the hypothalamic-pituitary-adrenal axis","volume":"40","author":"Fiad TM","year":"1994","unstructured":"Fiad TM, Kirby JM, Cunningham SK, McKenna TJ. The overnight single-dose metyrapone test is a simple and reliable index of the hypothalamic-pituitary-adrenal axis. Clin Endocrinol (Oxf). 1994;40(5):603\u2013609."},{"issue":"1","key":"b16","series-title":"J Clin Endocrinol Metab","first-page":"43","article-title":"The long-term predictive accuracy of the short synacthen (corticotropin) stimulation test for assessment of the hypothalamic-pituitary-adrenal axis","volume":"91","author":"Agha A","year":"2006","unstructured":"Agha A, Tomlinson JW, Clark PM, Holder G, Stewart PM. The long-term predictive accuracy of the short synacthen (corticotropin) stimulation test for assessment of the hypothalamic-pituitary-adrenal axis. J Clin Endocrinol Metab. 2006;91(1):43\u201347."},{"issue":"1","key":"b17","series-title":"J Clin Endocrinol Metab","first-page":"117","article-title":"Incidence and late prognosis of Cushing\u2019s syndrome: a population-based study","volume":"86","author":"Lindholm J","year":"2001","unstructured":"Lindholm J, Juul S, J\u00f8rgensen JO,  Incidence and late prognosis of Cushing\u2019s syndrome: a population-based study. J Clin Endocrinol Metab. 2001;86(1):117\u2013123."},{"issue":"5","key":"b18","series-title":"Clin Endocrinol (Oxf)","first-page":"623","article-title":"Cardiovascular function and glucocorticoid replacement in patients with hypopituitarism","volume":"43","author":"Dunne FP","year":"1995","unstructured":"Dunne FP, Elliot P, Gammage MD,  Cardiovascular function and glucocorticoid replacement in patients with hypopituitarism. Clin Endocrinol (Oxf). 1995;43(5):623\u2013629."},{"issue":"3","key":"b19","series-title":"Eur J Endocrinol","first-page":"251","article-title":"Higher glucocorticoid replacement doses are associated with increased mortality in patients with pituitary adenoma","volume":"177","author":"Hammarstrand C","year":"2017","unstructured":"Hammarstrand C, Ragnarsson O, Hall\u00e9n T,  Higher glucocorticoid replacement doses are associated with increased mortality in patients with pituitary adenoma. Eur J Endocrinol. 2017;177(3):251\u2013256."},{"issue":"2","key":"b20","series-title":"J Biomed Inform","first-page":"377","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris PA","year":"2009","unstructured":"Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377\u2013381."},{"key":"b21","series-title":"J Biomed Inform","first-page":"103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris PA","year":"2019","unstructured":"Harris PA, Taylor R, Minor BL,  The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208."},{"key":"b22","series-title":"BMJ","first-page":"l6039","article-title":"Investigating cortisol excess or deficiency: a practical approach","volume":"367","author":"Hanna FWF","year":"2019","unstructured":"Hanna FWF, Issa BG, Kevil B, Fryer AA. Investigating cortisol excess or deficiency: a practical approach. BMJ. 2019;367:l6039."},{"issue":"2","key":"b23","series-title":"Clin Endocrinol (Oxf)","first-page":"216","article-title":"Recovery of adrenal function after chronic secondary adrenal insufficiency in patients with hypopituitarism","volume":"85","author":"Munro V","year":"2016","unstructured":"Munro V, Tugwell B, Doucette S, Clarke DB, Lacroix A, Imran SA. Recovery of adrenal function after chronic secondary adrenal insufficiency in patients with hypopituitarism. Clin Endocrinol (Oxf). 2016;85(2):216\u2013222."},{"issue":"3","key":"b24","series-title":"Endocr J","first-page":"421","article-title":"Anterior pituitary function in patients with nonfunctioning pituitary adenoma: results of longitudinal follow-up","volume":"42","author":"Tominaga A","year":"1995","unstructured":"Tominaga A, Uozumi T, Arita K, Kurisu K, Yano T, Hirohata T. Anterior pituitary function in patients with nonfunctioning pituitary adenoma: results of longitudinal follow-up. Endocr J. 1995;42(3):421\u2013427."},{"issue":"11","key":"b25","series-title":"J Clin Endocrinol Metab","first-page":"5316","article-title":"Recovery of the hypothalamo-pituitary-adrenal axis after transsphenoidal adenomectomy for non-ACTH-secreting macroadenomas","volume":"104","author":"Pofi R","year":"2019","unstructured":"Pofi R, Gunatilake S, Macgregor V,  Recovery of the hypothalamo-pituitary-adrenal axis after transsphenoidal adenomectomy for non-ACTH-secreting macroadenomas. J Clin Endocrinol Metab. 2019;104(11):5316\u20135324."},{"key":"b26","series-title":"R: A Language and Environment for Statistical Computing","unstructured":"R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. https:\/\/www.Rproject.org\/"},{"issue":"1","key":"b27","series-title":"BMC Bioinformatics","first-page":"77","article-title":"pROC: an open-source package for R and S+ to analyze and compare ROC curves","volume":"12","author":"Robin X","year":"2011","unstructured":"Robin X, Turck N, Hainard A,  pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics. 2011;12(1):77."},{"key":"b28","series-title":"Ggplot2: Elegant Graphics for Data Analysis","author":"Wikham H","year":"2016","unstructured":"Wikham H. Ggplot2: Elegant Graphics for Data Analysis. Springer-Verlag;2016."},{"key":"b29","article-title":"Gt: easily create presentation-ready display tables. Github","author":"Iannone R","unstructured":"Iannone R, Cheng J, Schloerke B,  Gt: easily create presentation-ready display tables. Github. Accessed October 10, 2025. https:\/\/github.com\/rstudio\/gt"},{"issue":"5","key":"b30","series-title":"J Neurosurg","first-page":"1576","article-title":"Complications associated with microscopic and endoscopic transsphenoidal pituitary surgery: experience of 1153 consecutive cases treated at a single tertiary care pituitary center","volume":"130","author":"Agam MS","year":"2019","unstructured":"Agam MS, Wedemeyer MA, Wrobel B, Weiss MH, Carmichael JD, Zada G. Complications associated with microscopic and endoscopic transsphenoidal pituitary surgery: experience of 1153 consecutive cases treated at a single tertiary care pituitary center. J Neurosurg. 2019;130(5):1576\u20131583."},{"issue":"1","key":"b31","series-title":"Endocrine","first-page":"175","article-title":"Feasibility, safety, and outcomes of a stratified fast-track care trajectory in pituitary surgery","volume":"69","author":"Lobatto DJ","year":"2020","unstructured":"Lobatto DJ, Vliet Vlieland TPM, van den Hout WB,  Feasibility, safety, and outcomes of a stratified fast-track care trajectory in pituitary surgery. Endocrine. 2020;69(1):175\u2013187."},{"issue":"6","key":"b32","series-title":"Pituitary","first-page":"930","article-title":"Complication avoidance protocols in endoscopic pituitary adenoma surgery: a retrospective cohort study in 514 patients","volume":"24","author":"Thakur JD","year":"2021","unstructured":"Thakur JD, Corlin A, Mallari RJ,  Complication avoidance protocols in endoscopic pituitary adenoma surgery: a retrospective cohort study in 514 patients. Pituitary. 2021;24(6):930\u2013942."},{"issue":"5","key":"b33","series-title":"J Endocrinol Invest","first-page":"460","article-title":"Perioperative cortisol can predict hypothalamus-pituitary-adrenal status in clinically non-functioning pituitary adenomas","volume":"32","author":"Cozzi R","year":"2009","unstructured":"Cozzi R, Lasio G, Cardia A, Felisati G, Montini M, Attanasio R. Perioperative cortisol can predict hypothalamus-pituitary-adrenal status in clinically non-functioning pituitary adenomas. J Endocrinol Invest. 2009;32(5):460\u2013464."},{"issue":"7","key":"b34","series-title":"Neuroendocrinology","first-page":"639","article-title":"Second-day morning cortisol levels after transsphenoidal surgery are accurate predictors of secondary adrenal insufficiency with diagnostic cut-offs similar to those in non-stressed conditions","volume":"111","author":"Prencipe N","year":"2021","unstructured":"Prencipe N, Parasiliti-Caprino M, Gatti F,  Second-day morning cortisol levels after transsphenoidal surgery are accurate predictors of secondary adrenal insufficiency with diagnostic cut-offs similar to those in non-stressed conditions. Neuroendocrinology. 2021;111(7):639\u2013649."},{"issue":"3","key":"b35","series-title":"Neurosurgery","first-page":"616","article-title":"Recovery room cortisol predicts long-term glucocorticoid need after transsphenoidal surgery for pituitary tumors","volume":"84","author":"Qaddoura A","year":"2019","unstructured":"Qaddoura A, Shalung TN, Meier MP,  Recovery room cortisol predicts long-term glucocorticoid need after transsphenoidal surgery for pituitary tumors. Neurosurgery. 2019;84(3):616\u2013623."},{"issue":"11","key":"b36","series-title":"Exp Clin Endocrinol Diabetes","first-page":"709","article-title":"Early basal cortisol level as a predictor of hypothalamic-pituitary-adrenal (HPA) axis function after pituitary tumor surgery","volume":"128","author":"Polovina TS","year":"2020","unstructured":"Polovina TS, Kraljevic I, Solak M,  Early basal cortisol level as a predictor of hypothalamic-pituitary-adrenal (HPA) axis function after pituitary tumor surgery. Exp Clin Endocrinol Diabetes. 2020;128(11):709\u2013714."},{"key":"b37","series-title":"World Neurosurg","first-page":"168","article-title":"Early morning cortisol level as a predictive factor for long-term glucocorticoid replacement after pituitary surgery: a systematic review and meta-analysis","volume":"176","author":"Abdollahifard S","year":"2023","unstructured":"Abdollahifard S, Taherifard E, Sadeghi A, Farrokhi A, Cohen-Gadol AA, Palmisciano P. Early morning cortisol level as a predictive factor for long-term glucocorticoid replacement after pituitary surgery: a systematic review and meta-analysis. World Neurosurg. 2023;176:168\u2013178."},{"issue":"9","key":"b38","series-title":"Neuroendocrinology","first-page":"823","article-title":"Endocrine function after transsphenoidal surgery in patients with non-functioning pituitary adenomas: a systematic review and meta-analysis","volume":"112","author":"Pedersen MB","year":"2022","unstructured":"Pedersen MB, Dukanovic S, Springborg JB, Andreassen M, Krogh J. Endocrine function after transsphenoidal surgery in patients with non-functioning pituitary adenomas: a systematic review and meta-analysis. Neuroendocrinology. 2022;112(9):823\u2013834."},{"key":"b39","series-title":"Surg Neurol Int","first-page":"91","article-title":"Postoperative day 1 versus postoperative day 5 morning cortisol for predicting an intact hypothalamic-pituitary axis: a cohort analysis","volume":"10","author":"Dupepe E","year":"2019","unstructured":"Dupepe E, Patel D, Miller J, Rizo I, Vaughan TB, Riley K. Postoperative day 1 versus postoperative day 5 morning cortisol for predicting an intact hypothalamic-pituitary axis: a cohort analysis. Surg Neurol Int. 2019;10:91."},{"issue":"3","key":"b40","series-title":"Eur J Endocrinol","first-page":"255","article-title":"Earlier post-operative hypocortisolemia may predict durable remission from Cushing\u2019s disease","volume":"178","author":"Ironside N","year":"2018","unstructured":"Ironside N, Chatain G, Asuzu D,  Earlier post-operative hypocortisolemia may predict durable remission from Cushing\u2019s disease. Eur J Endocrinol. 2018;178(3):255\u2013263."},{"issue":"4","key":"b41","series-title":"J Neurosurg","first-page":"1054","article-title":"Clinical utility of routine postoperative morning cortisol monitoring in detecting new hypothalamic-pituitary-adrenal axis insufficiency following endoscopic transsphenoidal surgery for sellar lesions","volume":"132","author":"Jackanich A","year":"2020","unstructured":"Jackanich A, Tavakol S, Strickland BA,  Clinical utility of routine postoperative morning cortisol monitoring in detecting new hypothalamic-pituitary-adrenal axis insufficiency following endoscopic transsphenoidal surgery for sellar lesions. J Neurosurg. 2020;132(4):1054\u20131058."},{"issue":"2","key":"b42","series-title":"Neurosurg Rev","first-page":"1353","article-title":"Transsphenoidal pituitary adenoma resection: do early post-operative cortisol levels predict permanent long-term hypocortisolism?","volume":"45","author":"Butenschoen VM","year":"2022","unstructured":"Butenschoen VM, von Werder A, Bette S,  Transsphenoidal pituitary adenoma resection: do early post-operative cortisol levels predict permanent long-term hypocortisolism? Neurosurg Rev. 2022;45(2):1353\u20131362."},{"issue":"4","key":"b43","series-title":"Endocr Pract","first-page":"353","article-title":"Endocrine outcomes of transsphenoidal surgery for pituitary apoplexy versus elective surgery for pituitary adenoma","volume":"25","author":"Marcet P","year":"2019","unstructured":"Marcet P, Paluzzi J, Morrison A, Vale FL. Endocrine outcomes of transsphenoidal surgery for pituitary apoplexy versus elective surgery for pituitary adenoma. Endocr Pract. 2019;25(4):353\u2013360."},{"key":"b44","series-title":"Front Endocrinol (Lausanne)","first-page":"1286020","article-title":"Perioperative hormone level changes and their clinical implications in patients with pituitary adenoma: a retrospective study of 428 cases at a single center","volume":"14","author":"Zhao M","year":"2023","unstructured":"Zhao M, Li K, Niu H, Zhao Y, Lu C. Perioperative hormone level changes and their clinical implications in patients with pituitary adenoma: a retrospective study of 428 cases at a single center. Front Endocrinol (Lausanne). 2023;14:1286020."},{"issue":"2","key":"b45","series-title":"Pituitary","first-page":"171","article-title":"Reported outcomes in transsphenoidal surgery for pituitary adenomas: a systematic review","volume":"26","author":"Layard Horsfall H","year":"2023","unstructured":"Layard Horsfall H, Lawrence A, Venkatesh A,  Reported outcomes in transsphenoidal surgery for pituitary adenomas: a systematic review. Pituitary. 2023;26(2):171\u2013181."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/145\/1\/article-p59.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/145\/1\/article-p59.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/145\/1\/article-p59.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T09:54:50Z","timestamp":1794218090000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/145\/1\/article-p59.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":45,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2025.9.jns251261","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}