Social functioning longitudinal trajectory and its predictors in young and middle-aged postoperative pituitary tumor patients: A growth mixture model

Purpose: Pituitary adenoma and its treatments can significantly impact the social function of young and middleaged patients. Monitoring social functioning trajectories over time provides a more holistic understanding of patients' quality of life. We aimed to study the social functional trajectories and their predictors to achieve individualized and comprehensive management. Methods: A longitudinal prospective survey was conducted from January 2021 to December 2022 in Nanjing, China. The convenience sampling method was adopted to recruit the patients with pituitary adenoma who underwent transsphenoidal surgery at the neurosurgery department in a tertiary-grade A hospital. The general information questionnaire, social disability screening scale and postoperative pituitary adenoma symptom distress scale were applied in different stages. Growth mixture modeling and the Logistic regression were utilized to identify the trajectory subgroups and their predictors of the social function. Results: Of 225 patients, 33 (14.67%) experienced "progressively recovered function", while 192 (85.33%) exhibited "persistently impaired social function". Factors associated with persistently impaired social function included fertility status (OR = 0.167, p = 0.001), visual loss (OR = 0.154, p = 0.012), and electrolyte disturbances at 6th month (OR = 0.047, p = 0.003). Conversely, patients with high monthly income (OR = 0.116, p = 0.000), good family support (OR = 3.890, p = 0.006), and preoperative headache (OR = 4.129, p = 0.006) were more likely to show progressively recovered function after surgery. Conclusions: Patients with pituitary adenoma still experience social dysfunction six months after surgery. Fertility status, family support, economic status, and symptom distress were significant predictors. This study emphasizes the crucial role of symptom distress and family support, providing a basis for follow-up and intervention strategies.