2025 Poster Presentations
P218: SOCIAL DETERMINANTS OF HEALTH IN PITUITARY SURGERY: A CASE SERIES OF 48 PATIENTS
Emmajane G Rhodenhiser, BS; Cordelia M Orillac, MD; Carter Suryadevara, MD, PhD; Kenar Gelman, BA; Liya S Madhok; Alec E Vaezi, MD, PhD; Ricky Madhok, MD; NYU Langone Health
Introduction: Social Determinants of Health (SDOH) significantly influence medical and surgical outcomes. While the effect of SDOH on cancer tumor detection is well-documented, the impact on pituitary surgery remains unexplored.
Aim: This study considers the impact of SDOH on patients undergoing pituitary surgery at a single medical center.
Methods: We performed a retrospective analysis of patients that underwent pituitary surgery between January 2021 and June 2024. Patient demographic information included age, sex, primary language, and insurance type. Tumor metrics included tumor volume and secretion status. Surgical data included CSF leak status, resection type (total, sub-total, or biopsy), and post-operative hormone deficiency status.
Results: There were 48 patients (26 male). 37 were English speaking, and 11 spoke Spanish, Creole, Chinese, Hindi or Punjabi. The average tumor volume for English-speaking patients was 13 cm3, while for non-English-speakers (NES) it was 20 cm3 (p=0.39). 43% of English-speakers were on commercial insurance compared to 18% of NES. 55% of NES were on Medicaid, compared to 11% of English-speakers. 21% of English-speakers had a secreting tumor in comparison to 9% of NES.
Discussion: NES presented with larger tumors, suggesting a delay in presentation and diagnosis. This delay may be attributed to barriers in accessing healthcare services due to language and insurance. Additionally, NES exhibited a lower incidence of secreting tumors. This is significant because secreting tumors initially present as endocrine issues, requiring more extensive workup to be diagnosed as pituitary disorders.
Conclusion: SDOH, particularly language and insurance, impacts clinical presentation and course in patients undergoing pituitary surgery.