Differences in clinical, hormonal, and radiological presentation and in surgical outcomes in patients presenting with and without pituitary apoplexy. A multicenter study of 245 cases
Authors' conclusion
Surgical resection is more common in patients presenting with pituitary apoplexy than those without apoplexy; however, visual improvement and complete recovery of pituitary function is more common in patients without apoplexy. The risk of new pituitary deficits and permanent diabetes insipidus is higher in patients with apoplexy than in those without it.
Study context
- Population
- Patients with pituitary macroadenomas in three Spanish tertiary hospitals
- Participants
- 60 vs 185
- Exposure
- Pituitary apoplexy vs no apoplexy in macroadenomas
- Apoplexyn = 60
- Non-pituitary apoplexyn = 185reference
- Outcome
- Clinical, hormonal and radiological presentation
Methodological detailsmulticentre, 3 Spanish tertiary hospitals
- Multicentre
- 3 Spanish tertiary hospitals
Main finding
As reported in the abstract
- Apoplexy vs Non-pituitary apoplexy: P = 0.003
- Apoplexy vs Non-pituitary apoplexy: P = 0.011
- Apoplexy vs Non-pituitary apoplexy: P = 0.007
- Apoplexy vs Non-pituitary apoplexy: P = 0.039
- Apoplexy vs Non-pituitary apoplexy: P = 0.035
- Apoplexy vs Non-pituitary apoplexy: P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Surgical outcomesApoplexy vs Non-pituitary apoplexy · more frequent with apoplexy | OR, surgical remission 4.55 | P < 0.001 |
| Surgical outcomesNon-pituitary apoplexy vs Apoplexy · more common without apoplexy | OR, visual improvement 6.52 | P < 0.001 |
| Surgical outcomesNon-pituitary apoplexy vs Apoplexy · more common without apoplexy | OR, complete pituitary function recovery 2.37 | P < 0.001 |
Safety
| Outcome | Estimate | P value |
|---|---|---|
| Postoperative deficitsApoplexy vs Non-pituitary apoplexy · more common with apoplexy | OR, new pituitary deficits 13.29 | P < 0.001 |
| Postoperative deficitsApoplexy vs Non-pituitary apoplexy · more common with apoplexy | OR, permanent diabetes insipidus 3.40 | P = 0.022 |
Original publication
Differences in clinical, hormonal, and radiological presentation and in surgical outcomes in patients presenting with and without pituitary apoplexy. A multicenter study of 245 cases. Pituitary. Published 27 April 2023. doi:10.
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