OTHER-09 RATES AND PATTERNS OF CENTRAL DIABETES INSIPIDUS AFTER SURGERY FOR SELLAR AND PARASELLAR TUMORS AT THE KENYATTA NATIONAL HOSPITAL

Abstract

Abstract BACKGROUND Central Diabetes Insipidus (DI) is a common post operative complication after procedures for sellar and parasellar tumors. It is associated with increased morbidity, mortality and prolonged hospital stay. It is diagnosed clinically by symptoms of polyuria and polydipsia and measuring serum sodium and osmolality as well as urine osmolality and specific gravity (SG). There is limited data on rates and patterns of post operative central DI for tumors in this anatomically complex region even with increasing number surgeries being done for these tumors. OBJECTIVE To determine the rates and patterns of post-operative central Diabetes Insipidus in patients with sellar and parasellar tumors at the (Kenyatta National Hospital) KNH. STUDY DESIGN This was a descriptive cross-sectional study. Study Setting: The study was conducted at KNH Neurosurgery units and critical care units. Methodology: This study involved 24 participants following surgery for sellar and parasellar tumors. Informed consent was obtained from the participants. Clinical assessment for presence polyuria and polydipsia and laboratory measurement of serum sodium and urine SG for features for central DI was done. DATA RESULTS The mean age of the patients was 28.69 years, 70.8% were female and 29.2% were male. The most common tumor as confirmed by histology was craniopharyngioma seen in 33.3% of the patients. With regards to age craniopharyngioma, pilocytic astrocytoma and arachnoid cyst was seen in paediatric age group predominantly while meningioma and pituitary adenoma was more common in adults. Polyuria and polydipsia were the main clinical features seen post operatively in patients with Central DI. 69.2% presented with both polyuria and polydipsia, 30.8% presented with polyuria alone without polydipsia. The rate of post operative Central DI after surgery for sellar and parasellar tumors was 54.2%. The most common pattern was transient type occurring in 76.9% of the cases. Biphasic pattern was seen in 23.1%.