The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2018

REDCap is a secure web-based application and provides a useful tool for establishing a national audit of pituitary surgery (#242)

Kiri Langford 1 , Benjamin Kwan 1 2 , Minoli Abeysekera 1 , Romesh Rajaratnam 1 , Bronwyn Crawford 1 2
  1. Department of Endocrinology, Concord Repatriation General Hospital, Sydney, NSW, Australia
  2. Sydney Medical School, University of Sydney, Syndey, NSW, Australia

Recently there has been a call for a national registry of pituitary surgery to monitor safety and efficacy1. To date, the resources have not been available to initiate and coordinate this. REDCap2 is a user-friendly, web-based tool for building databases and is supported by many local health networks around Australia. Using REDCap, we conducted a 10-year (2008-2018) retrospective audit of pituitary surgery at Concord Repatriation General Hospital. There were 29 cases during this period. Most cases (59%) were performed by one surgeon. All cases were elective, except for one emergency. The majority were for the first pituitary surgery; 10% were for tumour recurrence. The median age of patients was 56 years. All were pituitary adenomas except two (one meningioma, one craniopharyngioma) and were predominantly non-functioning (78%). Median tumour size was 24 mm (range 5-59 mm). Suprasellar extension was observed in 76%, optic chiasm compression in 59%, cavernous sinus extension in 52%, and sella floor erosion in 24%. Nine patients (33%) had documented visual field defects prior to surgery. Transsphenoidal surgery was undertaken in the majority (90%); three patients underwent craniotomy. The median length of stay was 7 days. Postoperatively, CSF leak developed in 24%; one patient required endoscopic repair. Three patients had serious surgical complications (temporal lobe haemorrhage with mass effect; intraoperative right internal carotid artery injury; tension pneumocephalus requiring extraventricular drain insertion). There were no deaths. Transient and permanent diabetes insipidus was seen postoperatively in 45% and 10%, respectively. At discharge, 59% of patients were on glucocorticoids. Many factors influence pituitary surgery outcome including tumour size and invasiveness, surgical approach, reoperation, endocrinopathy, and patient co-morbidities. The measurement of outcomes requires assessing a combination of imaging, endocrine and clinical parameters. REDCap provides a suitable database for this. Our data adds support to the establishment of a national pituitary surgery database.

  1. McCormack AL, Burt MG. Optimising pituitary surgery outcomes in Australia: how much does size matter? Intern Med J 2017;47: 1225-7.
  2. Harris P et al. Research electronic data capture (REDCap) – A metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform. 2009;42: 377-81.