Villwock Jennifer A, Villwock Mark, Deshaies Eric, Goyal Parul
Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, NY.
Int Forum Allergy Rhinol. 2014 Sep;4(9):767-70. doi: 10.1002/alr.21356. Epub 2014 Aug 22.
Pituitary tumors comprise 10% to 15% of all diagnosed intracranial tumors; 90% are adenomas. Though benign, significant morbidity via compression of surrounding structures or aberrant hormone secretion can occur. This study investigated rates of pituitary tumor diagnoses and treatment trends from 1993 to 2011.
This study was a retrospective review of the 1993 to 2011 Nationwide Inpatient Sample for patients diagnosed with pituitary tumor as well as those patients who underwent pituitary tumor resection. Incidences of pituitary lesions, surgical approaches, and clinical and economic outcomes were evaluated.
The rate of primary and secondary diagnoses of pituitary tumor per 100,000 persons significantly grew over the study period (correlation coefficient = 0.934 and 0.987, respectively, p < 0.001); a significant increase in the number of pituitary resections performed annually (correlation coefficient = 0.942, p < 0.001) were also seen. Admissions with a primary diagnosis of pituitary neoplasm experienced significant decreases in length of stay over time (correlation coefficient = -0.913, p < 0.001) and mortality (correlation coefficient = -0.697, p = 0.001). Interestingly, hospital charges more than triple over the same time span (correlation coefficient = 0.970, p < 0.001). Transfrontal resections decreased linearly with time.
Pituitary tumor diagnoses and resections have grown significantly over the past 20 years. Transsphenoidal surgical resection among this patient population has increased significantly, whereas transfrontal resections have decreased.
垂体瘤占所有确诊颅内肿瘤的10%至15%;其中90%为腺瘤。尽管垂体瘤是良性的,但通过压迫周围结构或异常激素分泌仍可导致严重的发病率。本研究调查了1993年至2011年垂体瘤的诊断率和治疗趋势。
本研究是对1993年至2011年全国住院患者样本进行的回顾性分析,纳入了被诊断为垂体瘤的患者以及接受垂体瘤切除术的患者。评估了垂体病变的发生率、手术方式以及临床和经济结果。
在研究期间,每10万人中垂体瘤的初次和二次诊断率显著上升(相关系数分别为0.934和0.987,p<0.001);每年进行的垂体瘤切除术数量也显著增加(相关系数=0.942,p<0.001)。以垂体肿瘤为主要诊断的住院患者的住院时间(相关系数=-0.913,p<0.001)和死亡率(相关系数=-0.697,p=0.001)随时间显著下降。有趣的是,在同一时间段内,医院收费增加了两倍多(相关系数=0.970,p<0.001)。经额切除术随时间呈线性下降。
在过去20年中,垂体瘤的诊断和切除术显著增加。该患者群体中经蝶窦手术切除显著增加,而经额切除术减少。