Incidence of postoperative hyponatremia in neurosurgical patients in a hospital in Southern Colombia

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Abstract

Introduction:

Hyponatremia is the most frequently encountered electrolyte disorder in hospitalized patients, and its incidence is even greater when a neurological condition is present. A significant association has been found between hyponatremia and increases in mortality rates.

Objective:

To describe the incidence of hyponatremia in neurosurgical patients of a university hospital in southern Colombia.

Methods:

Descriptive, observational study that analyzed the medical records of adult patients admitted to the intensive care unit after having undergone a neurosurgical procedure in the period between 2014 and 2015. Perioperative characteristics and neurological outcomes were compared, central trend and scatter were calculated, and statistical confidence tests were applied.

Results:

A total of 79 patients were included in the study. The median age was 40 years and 73.4% were male. The most frequent diagnosis was head injury, followed by space-occupying lesion and non-traumatic subarachnoid hemorrhage. The incidence of hyponatremia was 25.3%; patients with a diagnosis of subarachnoid hemorrhage were 8 times more likely to have hyponatremia (odds ratio 8.0, 95% confidence interval: 1.777–36.018). Mortality for the group of patients presenting hyponatremia was 35%, and unfavorable neurological outcomes were present in 80%.

Conclusions:

Neurosurgical patients with a diagnosis of subarachnoid hemorrhage or space-occupying lesion associated with hyponatremia have a less favorable neurologic outcome, without circumstantially affecting mortality.

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