Prevalence, Timing, Causes, and Outcomes of Hyponatremia in Hospitalized Orthopaedic Surgery Patients

Abstract

Hyponatremia in orthopaedic patients is associated with longer, costlier hospitalizations. The factors that significantly increased the risk of developing postoperative hyponatremia were an older age, spine fusion, hip arthroplasty, and the amount of lactated Ringer solution used.

Preoperative Hyponatremia Is Associated with Reoperation and Prolonged Length of Hospital Stay following Total Knee Arthroplasty

“…with total joint arthroplasty patients) to study the association between preoperative hyponatremia and perioperative outcomes. 4,6,7 While the association between preoperative hyponatremia and increased adverse events in a TKA population is unknown, studies of hyponatremia in other surgical populations suggest that hyponatremia may be associated with adverse outcomes. 3,[8][9][10][11] As one of the most common surgical procedures, demand for TKA is expected to increase by an estimated 174% increase from 2003 by the year 2030.…”

Comparison of the incidences of hyponatremia in adult postoperative critically ill patients receiving intravenous maintenance fluids with 140 mmol/L or 35 mmol/L of sodium: retrospective before/after observational study

“…Hyponatremia is one of the common complications in postoperative patients [12]. The incidences of hyponatremia (defined as serum sodium concentration <135 mmol/L) were reported to be 24.9% in patients who underwent head and neck surgery [13], 27.9% in patients who underwent orthopedic surgery [14] and 59% in patients who underwent cardiac surgery [15]. Hyponatremia was shown to be an independent risk factor of poor outcomes in acutely ill patients [9], and it may contribute to the occurrence of hyponatremic encephalopathy, especially in pediatric patients [10].…”

Hyponatremia

“…15 Subsequent studies document the development of hyponatremia in patients admitted into the hospital for illness or surgery. 52,53 Hyponatremia which develops after admission, is referred to as "hospital acquired", which is different from "community acquired" hyponatremia which is diagnosed upon arrival. 54,55 The incidence of hospital acquired hyponatremia has ranged from 30-40% of patients treated in the ICU 56 to 30% of patients postoperatively.…”

“…54,55 The incidence of hospital acquired hyponatremia has ranged from 30-40% of patients treated in the ICU 56 to 30% of patients postoperatively. 52 Patients with hyponatremia demonstrate longer recovery times 55 and have poorer outcomes compared with patients being treated for similar conditions but remain normonatremic throughout their hospital stay. 1,57 It is widely hypothesized that the hyponatremia is more reflective of the actual disease state than the cause of poorer outcomes, although correction of dysnatremia has led to significant improvements in clinical outcomes in recent studies.…”