Purpose

To identify the independent risk factors for developing morbid hypothalamic obesity, to propose a predictive scoring system for morbid hypothalamic obesity, and to propose an algorithm for management in order to minimize the risk of developing morbid hypothalamic obesity in patients with pediatric craniopharyngioma.

Methods

A retrospective analysis of all pediatric craniopharyngioma patients diagnosed and treated at Boston Children’s Hospital (BCH) between 1985 and 2017. Analysis of the data was conducted using IBM SPSS Statistics.

Results

We identified 105 patients, 90 (47 males and 43 females) fulfilled the inclusion criteria. The median age of patients at time of diagnosis was 8.4 years. The median follow-up was 10.6 years. Morbid hypothalamic obesity was evident in 28 (31.1%) patients at the last follow-up visit. Age of patients at time of diagnosis > 10 years (P = 0.023), preoperative body mass index (BMI) > 95th percentile (P = 0.006), and preoperative papilledema (P < 0.001) were the independent risk factors for developing morbid hypothalamic obesity.

Conclusion

We developed a unique predictive scoring system in order to differentiate between patients with and without high risk for developing morbid hypothalamic obesity.

中文翻译：

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小儿颅咽管瘤患者病态下丘脑肥胖的新型预测评分系统。

目的

为了确定发展病态下丘脑肥胖的独立危险因素，提出病态下丘脑肥胖的预测评分系统，并提出一种管理算法，以最大程度地降低小儿颅咽管瘤患者发展病态下丘脑肥胖的风险。

方法

回顾性分析了1985年至2017年在波士顿儿童医院（BCH）诊断并治疗的所有小儿颅咽管瘤患者。使用IBM SPSS Statistics对数据进行分析。

结果

我们确定了105例患者，其中90例（男47例，女43例）符合纳入标准。诊断时患者的中位年龄为8.4岁。中位随访时间为10.6年。在最后一次随访中，有28名患者（31.1％）出现了病态的下丘脑肥胖。诊断时患者年龄>  10岁（P  = 0.023），术前体重指数（BMI）>  95％（P  = 0.006）和术前乳头水肿（P  <0.001）是发展为病态下丘脑肥胖的独立危险因素。

结论

我们开发了独特的预测评分系统，以区分有无患病性下丘脑肥胖症的高危患者和无患高危疾病的患者。