Race and Cerebrospinal Fluid Leaks: Concerning Associations after Endonasal Transsphenoidal Pituitary Resection
Year: 2024
Type: article
Study design: Observational Study
Abstract: Objective: To identify and describe differences in the rates of cerebrospinal fluid (CSF) leaks after transsphenoidal pituitary resection (TSPR) on a demographic basis. Design: Multi-institution health care database study. Setting: TriNetX research database. Methods: The database TriNetX was searched for rates of CSF leaks after TSPR. Patients were excluded if they had a CSF leak diagnosed any time prior to postoperative day number one. Demographic factors such as sex and race were compared in cohorts matched by other demographic characteristics, obstructive sleep apnea, body mass index categories, functional adenoma status, nicotine use, and concurrent lumbar drain placement. Results: A total of 8,741 patients were included in the analysis, with a total rate of postoperative CSF leak of 2.62%. After matching, race and sex were both significant risk factors for CSF leak, with Black patients having a higher risk when compared with White patients (risk ratio [RR]: 1.68, 95% confidence interval [CI]: 1.08-2.60) and females having a higher risk compared with males (RR: 1.33, 95% CI: 1.00-1.77). Conclusion: Even when matching for obstructive sleep apnea, weight, functional adenoma status, nicotine use, and concurrent lumbar drain placement, Black and female patients had higher rates of CSF leaks in the month following surgery. This finding highlights an important gap in the literature that should be addressed through future prospective studies and the need to better understand potential demographic disparities in health care.
DOI: 10.1055/a-2505-7941
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4405586577