Fouda Mohammed A, Zurakowski David, Scott R Michael, Marcus Karen J, Manley Peter E, Ullrich Nicole J, Cohen Laurie E, Goumnerova Liliana C
Department of Neurosurgery, Boston Children's Hospital, Boston, MA, USA.
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Childs Nerv Syst. 2021 Feb;37(2):403-410. doi: 10.1007/s00381-020-04877-z. Epub 2020 Sep 4.
To identify the independent risk factors for developing morbid hypothalamic obesity, to propose a predictive scoring system for morbid hypothalamic obesity, and to propose an algorithm for management in order to minimize the risk of developing morbid hypothalamic obesity in patients with pediatric craniopharyngioma.
A retrospective analysis of all pediatric craniopharyngioma patients diagnosed and treated at Boston Children's Hospital (BCH) between 1985 and 2017. Analysis of the data was conducted using IBM SPSS Statistics.
We identified 105 patients, 90 (47 males and 43 females) fulfilled the inclusion criteria. The median age of patients at time of diagnosis was 8.4 years. The median follow-up was 10.6 years. Morbid hypothalamic obesity was evident in 28 (31.1%) patients at the last follow-up visit. Age of patients at time of diagnosis > 10 years (P = 0.023), preoperative body mass index (BMI) > 95th percentile (P = 0.006), and preoperative papilledema (P < 0.001) were the independent risk factors for developing morbid hypothalamic obesity.
We developed a unique predictive scoring system in order to differentiate between patients with and without high risk for developing morbid hypothalamic obesity.
确定发生病态下丘脑性肥胖的独立危险因素，提出病态下丘脑性肥胖的预测评分系统，并提出一种管理算法，以尽量降低小儿颅咽管瘤患者发生病态下丘脑性肥胖的风险。
对1985年至2017年间在波士顿儿童医院（BCH）诊断和治疗的所有小儿颅咽管瘤患者进行回顾性分析。使用IBM SPSS Statistics对数据进行分析。
我们确定了105例患者，其中90例（47例男性和43例女性）符合纳入标准。患者诊断时的中位年龄为8.4岁。中位随访时间为10.6年。在最后一次随访时，28例（31.1%）患者出现明显的病态下丘脑性肥胖。诊断时患者年龄>10岁（P = 0.023）、术前体重指数（BMI）>第95百分位数（P = 0.006）和术前视乳头水肿（P < 0.001）是发生病态下丘脑性肥胖的独立危险因素。
我们开发了一种独特的预测评分系统，以区分发生病态下丘脑性肥胖风险高和低的患者。
