ArticlePituitary2026
The Limited Role of Hypocortisolism in the Development of Delayed Postoperative Hyponatremia After Pituitary Surgery.
Article in Pituitary, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDelayed postoperative hyponatremia (DPH) is a common complication following pituitary surgery. Although hypocortisolism has been proposed as a contributing factor, the temporal interplay between cortisol and sodium levels remains unclear. This study aimed to elucidate the relationship between postoperative cortisol and sodium dynamics, identify independent predictors of DPH and assess potential protective factors.
methodsWe retrospectively analyzed 261 patients who underwent fully endoscopic surgery for clinically non-functioning pituitary neuroendocrine tumors (Pit-NETs, also known as pituitary adenomas) between 2021 and 2024. Serial measurements of serum sodium and morning cortisol were collected from the immediate postoperative period through 3-month follow-up. Comparative analyses between patients with and without DPH were performed to characterize hormonal and electrolyte trends. The frequency of hypocortisolism during hyponatremic episodes was compared, and multivariable logistic regression identified independent predictors. The potential protective role of preoperative steroid replacement was also evaluated.
resultsDPH occurred in 54 patients (20.7%), with symptomatic cases accounting for 4.2% of the cohort. The median time to nadir sodium was 8 days with a median nadir of 129 mEq/L. The serum cortisol level between hyponatremia and non-hyponatremia group did not show significant differences. For propensity score matched comparison, median nadir cortisol levels were lower in the DPH group (6.10 vs. 7.34 µg/dL, p = 0.29), and hypocortisolism during hyponatremic episodes was more frequent (48.2% vs. 40.7%, p = 0.52), though neither difference reached statistical significance. Multivariate analysis identified age > 60 years (OR 2.09, 95% CI 1.11-3.96, p = 0.023) and postoperative pneumocephalus (OR 3.28, 95% CI 1.59-6.81, p = 0.001) as independent predictors. Preoperative cortisol replacement did not demonstrate a protective effect against DPH.
conclusionHypocortisolism does not appear to be the primary mechanism underlying DPH following pituitary surgery, as evidenced by the lack of temporal correlation. Advanced age and postoperative pneumocephalus emerge as key risk factors for DPH, supporting a multifactorial etiology. Although preoperative ACTH deficiency was linked to a higher incidence of DPH, preoperative cortisol replacement was not associated with protection.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.