Socioeconomic factors associated with pituitary apoplexy: Clinical article

Arman Jahangiri, Aaron J. Clark, Seunggu J. Han, Sandeep Kunwar, Lewis S. Blevins, Manish K. Aghi

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Object. Pituitary apoplexy is associated with worse outcomes than are pituitary adenomas detected without acute clinical deterioration. The association between pituitary apoplexy and socioeconomic factors that may limit access to health care has not been examined in prior studies. Methods. This study involved retrospectively evaluating data obtained in all patients who underwent surgery for nonfunctioning pituitary adenoma causing visual symptoms between January 2003 and July 2012 at the University of California, San Francisco. Patients were grouped into those who presented with apoplexy and those who did not ("no apoplexy"). The 2 groups were compared with respect to annual household income, employment status, health insurance status, and whether or not the patient had a primary health care provider. Associations between categorical variables were analyzed by chi-square test and continuous variables by Student t-test. Multivariate logistic regression was also performed. Results. One hundred thirty-five patients were identified, 18 of whom presented with apoplexy. There were significantly more unmarried patients and emergency room presentations in the apoplexy group than in the "no apoplexy" group. There was a nonsignificant trend toward lower mean household income in the apoplexy group. Lack of health insurance and lack of a primary health care provider were both highly significantly associated with apoplexy. In a multivariate analysis including marital status, emergency room presentation, income, insurance status, and primary health care provider status as variables, lack of insurance remained associated with apoplexy (OR 11.6; 95% CI 1.9-70.3; p = 0.008). Conclusions. The data suggest that patients with limited access to health care may be more likely to present with pituitary apoplexy than those with adequate access.

Original languageEnglish (US)
Pages (from-to)1432-1436
Number of pages5
JournalJournal of neurosurgery
Volume119
Issue number6
DOIs
StatePublished - Dec 1 2013

Keywords

  • Apoplexy
  • Insurance
  • Pituitary adenoma
  • Pituitary surgery
  • Socioeconomic factors
  • Vision

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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