Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/222226
Title: Predictors of conversion to surgery in pituitary apoplexy: Insights from a Spanish multicenter observational study
Author: Biagetti, Betina
Cordero Asanza, Esteban
Pérez López, Carlos
Rodríguez Berrocal, Víctor
Vicente, Almudena
Lamas, Cristina
Guerrero Pérez, Fernando
Simó Servat, Andreu
Serra, Guillermo
Irigaray Echarri, Ana
Ollero, María Dolores
González Molero, Inmaculada
Villar Taibo, Rocío
Moure Rodríguez, María Dolores
García Feijoo, Pablo
Sánchez Ramirez, María Noelia
Gutiérrez Hurtado, Alba
Capristan Díaz, Vanessa
Camara Gómez, Rosa
Gallach Martínez, Marta
Safont Pérez, Eva
González Rosa, Victoria
Civantos Modino, Soralla
Martínez Sáez, Elena
Menéndez Torre, Edelmiro Luis
Aulinas, Anna
Iglesias, Pedro
Diez, Juan J.
Bernabéu, Ignacio
Álvarez Escolá, Cristina
Puig Domingo, Manuel
Araujo Castro, Marta
Spanish Society of Endocrinology and Nutrition
Keywords: Malalties de la hipòfisi
Cirurgia cerebral
Pituitary gland diseases
Cerebral surgery
Issue Date: 11-May-2025
Publisher: Elsevier BV
Abstract: Background: Pituitary apoplexy (PA) is a rare but potentially life-threatening condition. While conservative management is an option in selected cases, predictors of conversion to surgery after initial conservative management remain unclear. Objective: To identify predictors of transitioning to surgery in PA who were initially managed conservatively, and to assess the timing and impact of surgical conversion. Methods: This multicenter observational study included 134 patients with PA initially managed conservatively. Patients were categorized into successful conservative management (no surgery or surgery scheduled after 30 days) and conversion to surgery (surgery within 8-30 days). Logistic and Cox regression analyses were performed to identify predictors of conversion to surgery and time to transition, respectively. Results: Among the 134 patients enrolled, the median age was 61.4 years (interquartile range: 16.0) years and 93 (69.4 %) men], 69 (51.5 %) ultimately required surgery, with most transitions occurring within the first two weeks. In logistic regression analysis, larger tumor size (OR: 1.09, 95 % CI: 1.02-1.16) and higher BMI (OR: 1.11, 95 % CI: 1.01-1.22) were independently associated with conversion to surgery. However, Cox regression did not identify any variables predicting time to transition. Additionally, patients who converted to surgery had a significantly longer hospital stay (21.0 vs. 7.5 days, p < 0.01). Conclusion: Half of the patients initially managed conservatively required convertion to surgery. Tumor size and BMI were associated with an increased likelihood of surgery, but no factors predicted when surgery would occur, suggesting that the decision to conversion to surgery may be influenced by multiple clinical factors rather than a single determinant.
Note: Reproducció del document publicat a: https://doi.org/10.1016/j.jcte.2025.100399
It is part of: Journal of Clinical & Translational Endocrinology, 2025, vol. 40, 100399
URI: https://hdl.handle.net/2445/222226
Related resource: https://doi.org/10.1016/j.jcte.2025.100399
ISSN: 2214-6237
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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