Postoperative intensive care management and residual endocrinopathy of pediatric supratentorial brain tumors: a retrospective cohort study
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Amir Babiker
,
Bothainah Alaqeel
,
Ayman Al-Eyadhy
Abstract
Objectives
Endocrinopathy can occur as a postoperative sequel in children treated for supratentorial tumors (STTs). We assessed prediction of a residual hypothalamic/pituitary insufficiency (HPI) in these patients and factors associated with prolonged length of hospital stay (LOS).
Methods
This is a retrospective cohort study of children who had surgery for STTs in two tertiary centers in Saudi Arabia (2009–2019). We assessed PICU postoperative management and risk of HPI. Data were analyzed using SPSS V24.0 and a logistic regression model for a prediction of a prolonged LOS.
Results
Data included 55 children (1–18 years, mean 9.5 ± 4.9 years) who required STT surgeries, 32 (54%) females. Craniopharyngioma (27.3%) was the commonest STTs and 20% of patients had initial symptoms of HPI. PICU management included the use of different types of intravenous fluids (IVFs) and medications such as steroids and desmopressin (DDAVP). An early postoperative DI was reported in 21.8% (n=12/55). Residual HPI included 24 (43.6%) presumed cortisol deficient and 18 (32.7%) central DI patients. Risk factors for postoperative HPI were female gender, age <6 years, headache and preoperative pituitary symptoms. LOS (Median=25.5 ± 12.2 days) was significantly prolonged in patients who required two or more doses of DDAVP [B=13; 95% CI= (1.7–24.3) days] and reduced in patients who had suspected preoperative HPI [B=−19.6; 95% CI= (−31.1, −8.2) days].
Conclusions
Prediction of postoperative HPI in pediatric STTs enhances an early initiation of treatment in PICU and reduces LOS. A meticulous use of IVF and medications supervised by a multidisciplinary team is essential for a favorable outcome.
Acknowledgment
The authors would like to thank the staff at KASCH who was cooperative in data collection especially medical records. Also, the IRB and scientific committee at KAIMRC for reviewing the design of the study and facilitating data collection. We also would like to thank the Analytics team at King Saud Bin Abdulaziz University for Health Sciences, Riyadh, for conducting the data analysis for this study.
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Research funding: King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia funded this research regarding expenses of logistics required to complete data collection and analysis as well as any required publication charges.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors declare no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: An Institutional Review Board approval was obtained from King Abdullah International Medical Research Center before beginning the study.
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review Articles
- The genetic elucidation of monogenic obesity in the Arab world: a systematic review
- Global perspective on pediatric growth hormone registries: a systematic review
- Mini Review
- Considering metformin as a second-line treatment for children and adolescents with prediabetes
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- Central adrenal insufficiency screening with morning plasma cortisol and ACTH levels in Prader–Willi syndrome
- Clinical characteristics and genetics analysis for the ITD of congenital hypothyroidism
- Genomic landscape of sporadic pediatric differentiated thyroid cancers: a systematic review and meta-analysis
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- Clinical, biochemical, and biomolecular aspects of congenital adrenal hyperplasia in a group of Cameroonian children and adolescents
- Ten year analysis of the clinic profile of the tertiary paediatric endocrine service in Western Australia
- Postoperative intensive care management and residual endocrinopathy of pediatric supratentorial brain tumors: a retrospective cohort study
- Successful telehealth transformation of a pediatric outpatient obesity teaching program due to the COVID-19 pandemic – the “Video KiCK” program
- Glycemic control among children with type 1 diabetes mellitus and its determinants in a resource-limited setting
- Letter to the Editor
- Anxiety, pediatric type 1 diabetes and COVID-19 lockdown
- Short Communication
- Ethnic diversity and burden of polycystic ovary syndrome among US adolescent females
- Case Reports
- Feminizing adrenocortical oncocytoma presenting as precocious puberty: a case report and literature review
- Novel OTX2 loss of function variant associated with congenital hypopituitarism without eye abnormalities
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Artikel in diesem Heft
- Frontmatter
- Review Articles
- The genetic elucidation of monogenic obesity in the Arab world: a systematic review
- Global perspective on pediatric growth hormone registries: a systematic review
- Mini Review
- Considering metformin as a second-line treatment for children and adolescents with prediabetes
- Original Articles
- Central adrenal insufficiency screening with morning plasma cortisol and ACTH levels in Prader–Willi syndrome
- Clinical characteristics and genetics analysis for the ITD of congenital hypothyroidism
- Genomic landscape of sporadic pediatric differentiated thyroid cancers: a systematic review and meta-analysis
- The role of circulating miRNAs in leptin resistance in obese children
- Relationship between height age, bone age and chronological age in normal children in the context of nutritional and pubertal status
- Clinical, biochemical, and biomolecular aspects of congenital adrenal hyperplasia in a group of Cameroonian children and adolescents
- Ten year analysis of the clinic profile of the tertiary paediatric endocrine service in Western Australia
- Postoperative intensive care management and residual endocrinopathy of pediatric supratentorial brain tumors: a retrospective cohort study
- Successful telehealth transformation of a pediatric outpatient obesity teaching program due to the COVID-19 pandemic – the “Video KiCK” program
- Glycemic control among children with type 1 diabetes mellitus and its determinants in a resource-limited setting
- Letter to the Editor
- Anxiety, pediatric type 1 diabetes and COVID-19 lockdown
- Short Communication
- Ethnic diversity and burden of polycystic ovary syndrome among US adolescent females
- Case Reports
- Feminizing adrenocortical oncocytoma presenting as precocious puberty: a case report and literature review
- Novel OTX2 loss of function variant associated with congenital hypopituitarism without eye abnormalities
- Bilateral Wilms’ tumor in a child with Denys-Drash syndrome: novel frameshift variant disrupts the WT1 nuclear location signaling region
- A very rare cause of arthrogryposis multiplex congenita: a novel mutation in TOR1A
