Higher Mortality Risk With Preoperative Hyponatremia

Also linked to more complications, including coronary events, wound infections, and pneumonia

FRIDAY, Sept. 14 (HealthDay News) -- Patients with preoperative hyponatremia have a higher risk of 30-day mortality and morbidity, including coronary events, surgical site wound infections, and pneumonia, according to research published online Sept. 10 in the Archives of Internal Medicine.

To determine whether preoperative hyponatremia is a predictor of 30-day perioperative morbidity and mortality, Alexander A. Leung, M.D., of Brigham and Women's Hospital in Boston, and colleagues conducted a cohort study involving 75,423 patients with preoperative hyponatremia (less than 135 mEq/L) and 888,840 patients with normal baseline sodium levels (135 to 144 mEq/L).

The researchers found that, in all subgroups, patients with preoperative hyponatremia were 44 percent more likely to die within 30 days of surgery compared with those with normal sodium levels. In addition, patients with preoperative hyponatremia undergoing nonemergency surgery were 59 percent more likely to die within 30 days and those who were American Society of Anesthesiology class 1 or 2 were 93 percent more likely. The risks of perioperative major coronary event, wound infection, and pneumonia were also higher for those with preoperative hyponatremia. Finally, median length of hospital stay was about one day longer.

"Although this study provides evidence that preoperative hyponatremia is associated with perioperative morbidity and mortality, further research is needed to establish whether correcting preoperative hyponatremia will mitigate risks," the authors write.

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