Frailty and pituitary surgery: a systematic review.

IF 3.3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pituitary Pub Date : 2025-03-17 DOI:10.1007/s11102-025-01507-2

Mendel Castle-Kirszbaum, Ann McCormack, Christopher Ovenden, Jeremy Kam, James King, Yi Yuen Wang, Tony Goldschlager

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引用次数: 0

Abstract

Background: Frailty is a state of physiological vulnerability rendering patients susceptible to adverse perioperative outcomes after neurosurgery. The effect of frailty on surgical success and complication rates in patients undergoing transsphenoidal pituitary surgery is unclear.

Methods: A systematic review of the literature was performed in accordance with the PRISMA statement. Studies that utilised validated metrics to report the effect of frailty on pituitary surgery were included.

Results: A total of 13 studies were included, comprising 124,989 patients. Frailty was exclusively assessed with cumulative deficit metrics, however there was significant heterogeneity in patient population, frailty definitions and assessment, and outcomes. Frail patients undergoing transsphenoidal surgery experienced higher rates of medical complications, resulting in longer hospital stays, greater hospitalisation costs, higher rates of unplanned readmission, more discharges to a destination other than home, and increased mortality. These outcomes directly correlated with increasing degrees of frailty. Surgical outcomes were not affected by frailty, with similar rates of biochemical remission, visual recovery, and improvement in quality of life.

Conclusion: Frailty is seen in a minority of patients undergoing pituitary surgery, but is an important indicator of perioperative risk. Frailty assessment should not be used as a reason to withhold surgery, but rather to predict and mitigate perioperative complications to improve outcomes in pituitary surgery.

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来源期刊

Pituitary 医学-内分泌学与代谢

CiteScore

7.10

自引率

7.90%

发文量

审稿时长

6 months

期刊介绍： Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.