Medical Student University of Mississippi Medical Center
Introduction: Race and demographic differences influence healthcare outcomes in pituitary tumor resections. Past studies exploring these differences have a narrow scope of investigation. This study aims to fill gaps in existing literature about racial disparities in pituitary tumor resections between African American and Caucasian patient populations.
Methods: A retrospective review of adult patients with pituitary tumor resections from January 2013 to July 2021 at a single academic medical center was performed. Patient data were manually collected utilizing the EPIC electronic health record system and managed using REDCap electronic data capture tools. Data on patient demographics, tumor characteristics, presenting symptoms, admission course, and outpatient course were collected. Parametric data were analyzed using two-way ANOVA and ANCOVA analyses, while nonparametric data were analyzed using chi-square, Fisher’s exact, and Kruskal-Wallis tests.
Results: Our analysis included 188 surgical cases with 177 unique patients. Caucasian race was associated with higher incidence of reoperations (p=0.041). African American race was associated with larger tumor size (p=0.014). Caucasian race was associated with higher incidence of functional tumors (p=0.003). African American race was associated with higher incidence of prolactinomas (p=0.008) and gonadotrophs (p=0.001). Conversely, Caucasian race was associated with higher incidence of ACTHomas (p=0.015). Caucasian race presented with a higher incidence of hormonal dysfunction (p < 0.001). The mean number of admission complications was observed to be higher in African Americans (p=0.006). Within the female sex, African Americans had a higher incidence of postoperative diabetes insipidus (DI) (p=0.003).
Conclusion : Our study showed significant findings associated with race, preoperative characteristics, and postoperative health outcomes of pituitary tumor resections. African Americans were more likely to have larger tumor size, higher occurrence of prolactinomas and gonadotrophs, higher mean number of admission complications, and higher occurrence of postoperative DI. This study adds to the growing body of literature regarding racial disparities in pituitary tumors and postoperative outcomes.
