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John Paul M. Quisumbing  (Quisumbing JPM) 1 Article
Clinical Study
Factors Associated with Postoperative Diabetes Insipidus after Pituitary Surgery
Antonio L. Faltado, Anna Angelica Macalalad-Josue, Ralph Jason S. Li, John Paul M. Quisumbing, Marc Gregory Y. Yu, Cecilia A. Jimeno
Endocrinol Metab. 2017;32(4):426-433.   Published online November 21, 2017
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  • 9 Citations
AbstractAbstract PDFPubReader   CrossRef-TDMCrossref - TDM

Determining risk factors for diabetes insipidus (DI) after pituitary surgery is important in improving patient care. Our objective is to determine the factors associated with DI after pituitary surgery.


We reviewed records of patients who underwent pituitary surgery from 2011 to 2015 at Philippine General Hospital. Patients with preoperative DI were excluded. Multiple logistic regression analysis was performed and a predictive model was generated. The discrimination abilities of the predictive model and individual variables were assessed using the receiving operator characteristic curve.


A total of 230 patients were included. The rate of postoperative DI was 27.8%. Percent change in serum Na (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.15 to 1.69); preoperative serum Na (OR, 1.19; 95% CI, 1.02 to 1.40); and performance of craniotomy (OR, 5.48; 95% CI, 1.60 to 18.80) remained significantly associated with an increased incidence of postoperative DI, while percent change in urine specific gravity (USG) (OR, 0.53; 95% CI, 0.33 to 0.87) and meningioma on histopathology (OR, 0.05; 95% CI, 0.04 to 0.70) were significantly associated with a decreased incidence. The predictive model generated has good diagnostic accuracy in predicting postoperative DI with an area under curve of 0.83.


Greater percent change in serum Na, preoperative serum Na, and performance of craniotomy significantly increased the likelihood of postoperative DI while percent change in USG and meningioma on histopathology were significantly associated with a decreased incidence. The predictive model can be used to generate a scoring system in estimating the risk of postoperative DI.


Citations to this article as recorded by  
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  • Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study
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    Kunzhe Lin, Kaichun Fan, Shuwen Mu, Shousen Wang
    European Journal of Medical Research.2022;[Epub]     CrossRef
  • Change in the pituitary stalk deviation angle after transsphenoidal surgery can predict the development of diabetes insipidus for pituitary adenomas
    Liang Xue, Jianwu Wu, Jie Chen, Yongkai Yang
    Endocrine Connections.2022;[Epub]     CrossRef
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    Emily K Brooks, Warrick J Inder
    The Journal of Clinical Endocrinology & Metabolism.2022; 108(1): 198.     CrossRef
  • Postoperative diabetes insipidus: how to define and grade this complication?
    Friso de Vries, Daniel J. Lobatto, Marco J. T. Verstegen, Wouter R. van Furth, Alberto M. Pereira, Nienke R. Biermasz
    Pituitary.2021; 24(2): 284.     CrossRef
  • Diaphragma sellae sinking can predict the onset of hyponatremia after transsphenoidal surgery for pituitary adenomas
    Kunzhe Lin, Jun Li, Lingling Lu, Shangming Zhang, Shuwen Mu, Zhijie Pei, Cheng Wang, Jingying Lin, Liang Xue, Liangfeng Wei, Lin Zhao, Shousen Wang
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  • Adrenocorticotropic hormone-secreting pituitary macroadenoma: A pictorial case report and review
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    Indian Journal of Continuing Nursing Education.2021; 22(2): 137.     CrossRef
  • Sodium Perturbations After Pituitary Surgery
    Kevin C.J. Yuen, Adnan Ajmal, Ricardo Correa, Andrew S. Little
    Neurosurgery Clinics of North America.2019; 30(4): 515.     CrossRef

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