title: Morbidity and mortality in patients with craniopharyngioma after surgery.
abstract: OBJECTIVE
  Craniopharyngioma (CP) is a benign tumour of the suprasellar region that is associated with increased morbidity and mortality in comparison with other causes of hypopituitarism. We aimed to establish the rate and causes of mortality and morbidity in patients with CP who attended our centre.
  
  
  METHODS
  We performed a retrospective case note audit of patients with CP who were managed by our service. We established the standardized mortality ratio (SMR) for patients with CP. We compared obesity prevalence with two other hypopituitary groups who are managed by our service.
  
  
  METHODS
  We identified 70 patients with CP, 97% of whom had undergone surgery and 42% radiotherapy. We compared the prevalence of obesity with that of 89 patients with hypopituitarism secondary to surgery for nonfunctioning pituitary adenoma and 29 patients with post-traumatic hypopituitarism (PTHP).
  
  
  METHODS
  Standardized mortality ratio for patients with CP was 8.75 (95% CI of 5.4-13.3); SMR for women was 10.51 (95% CI 5.04-19.3) and 7.55 (95% CI 3.77-13.52) for men. The rates of growth hormone (GH), gonadotrophin, adrenocorticotrophic hormone (ACTH) and TSH deficiencies were 91%, 93.5%, 92% and 86%, respectively. The rate of diabetes insipidus (DI) was 81%; 7.1% had adipsic DI. Dyslipidaemia was present in 46.9% and diabetes mellitus in 11.5%. Obesity affected 66% of patients with CP, 47% of patients with nonfunctioning adenoma and 31% of those with PTHP (P < 0.001).
  
  
  CONCLUSIONS
  Patients with CP suffer from high rates of mortality and morbidity. The underlying causes for mortality and for obesity in this population remain poorly understood.
authors.affiliation: Academic Department of Endocrinology, Beaumont Hospital, Dublin, UK. rachelcrowley@hotmail.com
authors.forename: R K
authors.initials: RK
authors.lastname: Crowley
authors.forename: O P
authors.initials: OP
authors.lastname: Hamnvik
authors.forename: E P
authors.initials: EP
authors.lastname: O'Sullivan
authors.forename: L A
authors.initials: LA
authors.lastname: Behan
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: A
authors.initials: A
authors.lastname: Agha
authors.forename: C J
authors.initials: CJ
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000172:deficiency; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000401:mortality* / Q000601:surgery; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010911:Pituitary Neoplasms / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies; D012727:Sex Characteristics
chemical_list: D019382:Human Growth Hormone; D000324:Adrenocorticotropic Hormone