Hypopituitarism and associated demographic and clinical factors in patients with pituitary adenoma in Ghana: a hospital-based retrospective study

Background: Pituitary adenoma is considered one of the main causes of hypopituitarism, which is characterised by a deficiency of one or more pituitary hormones. Clinical features of hypopituitarism may be non-specific, leading to diagnostic delays and an increased risk of morbidity and mortality in affected patients. Objective: This study aimed to determine the prevalence and associated factors of hypopituitarism among pituitary adenoma patients attending the Korle Bu Teaching Hospital, a tertiary hospital in southern Ghana. Methods: In this retrospective study, the clinical records of patients diagnosed with pituitary adenoma were reviewed to obtain demographic and clinical data. Pretreatment hypopituitarism, the main outcome measure, was defined as a deficiency of one or more anterior pituitary hormones prior to any therapeutic intervention. Data was analysed using Stata 16.1, and the level of significance was set at p < 0.05. Results: The prevalence of pretreatment hypopituitarism was 54.51% (95% CI, 47.92 - 60.35) and was associated with older age (Odds Ratio (OR) 2.79; 95% CI 1.41 - 5.50), male sex (OR 2.51; 95%CI 1.47 - 4.28), referral from a primary care facility (OR 4.50; 95% CI 1.39 - 14.47), non-functional pituitary adenoma (OR 4.87; 95% CI 2.78 - 8.56), macroadenoma (OR 9.75; 95%CI 4.15-22.9) and visual field defects (OR 6.35; 95% CI 3.19 - 12.62. Non-functional pituitary adenoma (Adjusted Odds Ratio (aOR) 3.03; 95% CI 1.35 - 6.76) and macroadenomas (aOR 9.62; 95% CI 2.76 - 33.39) were determinants of pretreatment hypopituitarism in patients with pituitary adenoma. Conclusion: The prevalence of pretreatment hypopituitarism was found to be 54.51% among pituitary adenoma patients attending the Korle Bu Teaching Hospital, a tertiary hospital in southern Ghana, from 1997 to 2019. Non-functional pituitary adenoma and macroadenoma were determinants of pretreatment hypopituitarism. Increasing awareness of the associated factors of hypopituitarism among clinicians could facilitate an early diagnosis and appropriate management to avoid the attendant adverse outcomes in patients with pituitary adenoma.