Preoperative hyponatremia and perioperative complications.

Background Although hyponatremia has been linked to increased morbidity and mortality in a variety of medical conditions, its association with perioperative outcomes remains uncertain. Methods To determine whether preoperative hyponatremia is a predictor of 30-day perioperative morbidity and mortality, we conducted a cohort study using the American College of Surgeons National Surgical Quality Improvement Program database to identify 964 263 adults undergoing major surgery from more than 200 hospitals (from January 1, 2005, to December 31, 2010) and observed them for 30-day perioperative outcomes. We used multivariable logistic regression to estimate relative risks for death, major coronary events, wound infections, and pneumonia occurring within 30 days of surgery and quantile regression to estimate differences in average length of hospital stay. Results A total of 75 423 patients with preoperative hyponatremia (sodium level Conclusion Preoperative hyponatremia is a prognostic marker for perioperative 30-day morbidity and mortality.

[1]  C. Stefanadis,et al.  Significance of Hyponatremia in Heart Failure , 2012 .

[2]  Jennie Z Ma,et al.  Hyponatremia, Hypernatremia, and Mortality in Patients With Chronic Kidney Disease With and Without Congestive Heart Failure , 2012, Circulation.

[3]  F. Jamali,et al.  Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study , 2011, The Lancet.

[4]  J. Ghali.  Is hyponatremia a marker or a mediator? , 2011, The American journal of medicine.

[5]  H. Weed.  Outcomes of preoperative medical consultation. , 2011, Archives of internal medicine.

[6]  陶仲为,et al.  Hyponatremia , 2010 .

[7]  Martin H. Dauber,et al.  Miller’s Anesthesia , 2010 .

[8]  L. Price,et al.  Impact of hospital-associated hyponatremia on selected outcomes. , 2010, Archives of internal medicine.

[9]  S. Waikar,et al.  Mortality after hospitalization with mild, moderate, and severe hyponatremia. , 2009, The American journal of medicine.

[10]  R. Fisher,et al.  Effect of hyponatraemia on outcomes following orthotopic liver transplantation , 2009, Liver international : official journal of the International Association for the Study of the Liver.

[11]  T. Therneau,et al.  Impact of pretransplant hyponatremia on outcome following liver transplantation , 2009, Hepatology.

[12]  N. Madias,et al.  Epidemiology of hyponatremia. , 2009, Seminars in nephrology.

[13]  G. Pilkington,et al.  INCLUSION/EXCLUSION CRITERIA , 2008 .

[14]  C. Mélot,et al.  Mild hyponatremia and risk of fracture in the ambulatory elderly. , 2008, QJM : monthly journal of the Association of Physicians.

[15]  A. Shorr,et al.  Epidemiology, clinical and economic outcomes of admission hyponatremia among hospitalized patients* , 2008, Current medical research and opinion.

[16]  P. Friedmann,et al.  Preoperative hematocrit levels and postoperative outcomes in older patients undergoing noncardiac surgery. , 2007, JAMA.

[17]  M. Niederman,et al.  Hyponatremia in Community-Acquired Pneumonia , 2007, American Journal of Nephrology.

[18]  N. Beeching,et al.  Hyponatraemia as a risk factor for hospital mortality. , 2006, QJM : monthly journal of the Association of Physicians.

[19]  David Wile,et al.  Characteristics and mortality of severe hyponatraemia – a hospital‐based study , 2006, Clinical endocrinology.

[20]  N. Madias,et al.  Incidence and prevalence of hyponatremia. , 2006, The American journal of medicine.

[21]  G. Decaux.  Is asymptomatic hyponatremia really asymptomatic? , 2006, The American journal of medicine.

[22]  M. Moritz,et al.  Dysnatremias: why are patients still dying? , 2006, Southern medical journal.

[23]  S. Khuri,et al.  The NSQIP: a new frontier in surgery. , 2005, Surgery.

[24]  Xiaonan Xue,et al.  Estimating the relative risk in cohort studies and clinical trials of common outcomes. , 2003, American journal of epidemiology.

[25]  A. Maggi,et al.  Clinical relevance of hyponatraemia for the hospital outcome of cirrhotic patients. , 2000, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[26]  S Greenland,et al.  A critical look at methods for handling missing covariates in epidemiologic regression analyses. , 1995, American journal of epidemiology.

[27]  D. Macpherson,et al.  An internist joins the surgery service , 1994, Journal of General Internal Medicine.

[28]  Douglas K. Martin,et al.  The prognosis of hyponatremia at hospital admission , 1986, Journal of General Internal Medicine.

[29]  A. Bader.  Advances in preoperative risk assessment and management. , 2012, Current problems in surgery.

[30]  S. Waikar,et al.  Mortality associated with low serum sodium concentration in maintenance hemodialysis. , 2011, The American journal of medicine.

[31]  王晓燕.  Arch Intern Med:住院增加老年人出院后骨折危险 , 2009 .

[32]  M. Manto,et al.  Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. , 2006, The American journal of medicine.