Prevalence of pituitary dysfunction after aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis

BMC Neurology

卷:23

Research

Fan Meng¹  Ming Zhang²  Baosheng Huang²  Xiaowei Song²  Xiaokui Gan²  Shengnan Cong³ 

[1] Department of Clinical Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, China;

[2] Department of Neurosurgery, Sir Run Run Hospital, Nanjing Medical University, Jiangsu, China;

[3] Department of Nursing, Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China;

关键词: Pituitary hormone dysfunction;    Aneurysmal subarachnoid hemorrhage;    Global prevalence;   

DOI  :  10.1186/s12883-023-03201-x

 received in 2022-11-14, accepted in 2023-04-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPituitary dysfunction (PD) is a common complication after aneurysmal subarachnoid hemorrhage (aSAH). The prevalence of PD varies widely at a global level and no recent meta-analysis is available. Therefore, the aim of our systematic review and meta-analysis was to summarize the updated estimates of worldwide prevalence of PD after aSAH.MethodsScopus, Embase, Web of Science, and PubMed databases were used to comprehensively search the appropriate literature and a random-effects meta-analysis on the results of the available studies was performed. The heterogeneity in the prevalence estimates was evaluated by subgroup analysis in terms of types of PD, and acute and chronic phases of aSAH. The onset of PD within 6 months after aSAH was considered as acute, while that after 6 months was considered as chronic.ResultsTwenty-seven studies with 1848 patients were included in this analysis. The pooled prevalence of PD in the acute phase was 49.6% (95% CI, 32.4-66.8%), and 30.4% (95% CI, 21.4-39.4%) in the chronic phase. Among the hormonal deficiencies, growth hormone dysfunction was the most prevalent in the acute phase, being 36.0% (95% CI, 21.0-51.0%), while hypoadrenalism was the most prevalent in the chronic phase, being 21.0% (95% CI, 12.0-29.0%). Among the six World Health Organization regions, the South-East Asia Region has the highest prevalence of PD in the acute phase (81.0%, 95%CI, 77.0-86.0%, P < 0.001), while the European Region had the highest prevalence of PD in the chronic phase (33.0%, 95%CI, 24.0-43.0%, P < 0.001). Moreover, single pituitary hormonal dysfunction occurred more frequently than the multiple one, regardless of acute or chronic phase.ConclusionsAlmost half (49.6%) of the included patients with aSAH developed PD complication in the acute phase, while 30.4% of the patients developed them in the chronic phase. Although prevalence varies globally, the high healthcare burden, morbidity and mortality require greater awareness among clinicians.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Scheme 1.