The Association Between COPD and In-hospital Outcomes for Patients Underwent Trans-sphenoidal Pituitary Surgery: Insight From National Database

Objective:
COPD is a common comorbidity in patients who underwent different types of procedures. Studies investigating the association between COPD and hospital outcomes for patients who underwent Transsphenoidal Pituitary Surgery (TSS) are very limited.

Methods:
Patients who underwent TSS with and without a previous diagnosis of COPD were found in the National Inpatient Sample Database from 2016 to 2019. The risk of in-hospital outcomes in the COPD group was compared to the non-COPD group using univariate and multivariate logistic regression analyses. Patient and facility characteristics, as well as comorbidities, were adjusted into the results.

Results:
A history of COPD was present in 135 (3.7%) of 3,560 patients who underwent TSS and were included in the study. The cohort sample had an average age of 53, a female gender representation of 53.4%, and a white ethnicity of 64%. The average total hospital charges 104,226 US dollars, while the average length of stay (LOS) was 4.3 days. The total number of patients who died during the admission was 15 and all have no previous history of COPD. There was no significant difference between the COPD and non-COPD groups in the risk of post-procedural CSF leak (OR 0.56, 95% CI 0.17–1.8, p=0.336), diabetes insipidus (OR 0.49, 95% CI 0.05–4.4, p=0.529) or urinary retention (OR 2.7, 95% CI 0.11–65.4, p=0.522). COPD was not associated with an increased mean of total hospital charges (118,899 vs 103,661 $, p=0.818) or the mean LOS (6.7 vs 4.2 days, p=0.496).

Discussion/Conclusion:
The study found no conclusive evidence that COPD significantly increased the risk of postoperative CSF leak, diabetes insipidus, or urine retention in individuals undergoing trans-sphenoidal pituitary surgery. COPD was not associated with an increased mean of total hospital charges or the mean LOS.