Characteristics Associated with Prolonged Post-Surgical Stays in Patients Operated by Transsphenoidal Endoscopic Surgery for Pituitary Adenoma

Introduction: In addition to intraoperative processes, certain characteristics of pituitary adenomas may be associated with the duration of postoperative hospital stays. Objective: To determine the characteristics associated with prolonged postoperative hospital stays in patients undergoing endoscopic transsphenoidal surgery for pituitary adenoma. Materials and methods: An analytical cross-sectional study was con-ducted using a secondary database (n = 704). Postoperative hospital length of stay, tumor subtype, tumor size, body mass index, American Society of Anesthesiologists (asa) physical status classification, age group, sex, and surgical reintervention were evaluated. Bivariate analyses, decision tree models using the Chi-Square Automatic Interaction Detection (chaid) algorithm, and multivariable logistic regression were employed to assess independent associations between clinical variables and prolonged hospital stay. Results: In men, null cell and lactotroph adenomas were associated with a postoperative hospital stay ≥4 days, whereas in women, null cell, gonadotroph, and lactotroph adenomas were associated with prolonged stay. In the multivariable analysis adjusted for clinical and surgical covariates, the somatotroph subtype, macroadenoma size, and obesity were significantly associated with prolonged hospital stay. Conclusions: Tumor subtype was associated with postoperative hospital length of stay in patients undergoing endoscopic transsphenoidal surgery for pituitary adenoma. This association remained after adjustment for relevant clinical and surgical variables, suggesting potential utility for postoperative risk stratification.