Hypothalamus-pituitary Dysfunction as an Independent Risk Factor for Postoperative Central Nervous System Infections in Patients with Sellar Region Tumors

Abstract

Objective: The purpose of this study was to verify that hypothalamus-pituitary dysfunction is one of the risk factors for postoperative central nervous system infections (PCNSIs).Method: We performed a retrospective analysis of all patients with sellar region lesions who underwent surgery between January 2016 and November 2019 at Peking Union Medical College Hospital. In total, 44 age‑ and sex-matched controls were enrolled. Univariate and multivariate analyses were performed to identify risk factors for PCNSIs.Result: We enrolled 88 patients, 44 of whom had PCNSIs. Surgical approach (TCS) (P<0.001), previous surgery on the same site (P=0.001), intraoperative cerebral spinal fluid (CSF) leakage (P<0.001), postoperative adrenal insufficiency (P=0.017), and postoperative DI (P=0.004) correlated significantly with PCNSIs. Multivariate analysis showed that intraoperative CSF leakage (OR:13.754; 95%CI: 3.482-54.328; P<0.001), postoperative diabetes insipidus (DI) (OR: 6.261; 95%CI: 1.114-35.189; P=0.037) and postoperative adrenal insufficiency (OR: 7.153; 95%CI: 1.071-47.764; P=0.042) were independent influencing factors for PCNSIs.Conclusion: Intraoperative CSF leakage, postoperative DI and postoperative adrenal insufficiency are risk factors for PCNSIs in patients with sellar region tumors.