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Health‐related quality of life in patients treated for nonfunctioning pituitary adenomas during the years 2000–2010
Author(s) -
Karppinen Atte,
Ritvonen Elina,
Roine Risto,
Sintonen Harri,
Vehkavaara Satu,
Kivipelto Leena,
Grossman Ashley B.,
Niemelä Mika,
SchalinJäntti Camilla
Publication year - 2016
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12967
Subject(s) - medicine , hypopituitarism , quality of life (healthcare) , depression (economics) , body mass index , population , sexual function , transsphenoidal surgery , hydrocortisone , multivariate analysis , testosterone (patch) , distress , endocrinology , adenoma , pituitary adenoma , nursing , environmental health , economics , macroeconomics , clinical psychology
Summary Objective The published data on health‐related quality of life ( HRQ oL) after treatment of nonfunctioning pituitary adenomas ( NFPA s) are conflicting. We evaluated HRQ oL in a recent series of patients who had surgery for an NFPA . Design Cross‐sectional study including a large control population. Patients and Measurements A HRQ oL questionnaire (15D) was sent to all patients ( n = 161) having undergone transsphenoidal surgery for NFPA in the years 2000–2010 at the Helsinki University Hospital. The 15D score and dimension scores of the study population ( n = 137) were compared with those of a large ( n = 4967) gender‐ and age‐standardized control population. Possible independent predictors of HRQ oL in the patients were estimated with multivariate regression analysis. Results Postoperatively, 57% of the patients had normal visual function. After a mean follow‐up of 7·4 ± 3·2 years (mean ± SD ), 62% suffered from hypopituitarism. Overall, HRQ oL was near‐normal in patients compared to controls (15D scores 0·885 ± 0·114 vs 0·903 ± 0·093, respectively, P = 0·07). On single dimensions, patients had impaired vision and sexual activity (both P < 0·0005), more depression and distress (both P < 0·005) and less discomfort and symptoms ( P < 0·05). Age, body mass index, diabetes, depression and reoperation were independent predictors of impaired HRQ oL (all P < 0·05). Thyroxine substitution was associated with impaired and hydrocortisone and testosterone substitution (males only) with better HRQ oL (all P < 0·05). Conclusions This recent series of NFPA patients demonstrates that overall HRQ oL is near‐normal after medium term follow‐up; the most impaired dimensions were in vision and sexual activity. Comorbidities are strong predictors of impaired HRQ oL.