Hussein, Z;
Tzoulis, P;
Marcus, HJ;
Grieve, J;
Dorward, N;
Bouloux, PM;
Baldeweg, SE;
(2022)
The management and outcome of hyponatraemia following transsphenoidal surgery: a retrospective observational study.
Acta Neurochirurgica
10.1007/s00701-022-05134-9.
(In press).
Preview |
Text
Hussein2022_Article_TheManagementAndOutcomeOfHypon.pdf - Published Version Download (855kB) | Preview |
Abstract
PURPOSE: Hyponatraemia is a common complication following transsphenoidal surgery. However, there is sparse data on its optimal management and impact on clinical outcomes. The aim of this study was to evaluate the management and outcome of hyponatraemia following transsphenoidal surgery. METHODS: A prospectively maintained database was searched over a 4-year period between January 2016 and December 2019, to identify all patients undergoing transsphenoidal surgery. A retrospective case-note review was performed to extract data on hyponatraemia management and outcome. RESULTS: Hyponatraemia occurred in 162 patients (162/670; 24.2%) with a median age of 56 years. Female gender and younger age were associated with hyponatraemia, with mean nadir sodium being 128.6 mmol/L on postoperative day 7. Hyponatraemic patients had longer hospital stay than normonatraemic group with nadir sodium being inversely associated with length of stay (p < 0.001). In patients with serum sodium ≤ 132 mmol/L, syndrome of inappropriate antidiuretic hormone secretion (SIADH) was the commonest cause (80/111; 72%). Among 76 patients treated with fluid restriction as a monotherapy, 25 patients (25/76; 32.9%) did not achieve a rise in sodium after 3 days of treatment. Readmission with hyponatraemia occurred in 11 cases (11/162; 6.8%) at a median interval of 9 days after operation. CONCLUSIONS: Hyponatraemia is a relatively common occurrence following transsphenoidal surgery, is associated with longer hospital stay and risk of readmission and the effectiveness of fluid restriction is limited. These findings highlight the need for further studies to better identify and treat high-risk patients, including the use of arginine vasopressin receptor antagonists.
| Type: | Article |
|---|---|
| Title: | The management and outcome of hyponatraemia following transsphenoidal surgery: a retrospective observational study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00701-022-05134-9 |
| Publisher version: | https://doi.org/10.1007/s00701-022-05134-9 |
| Language: | English |
| Additional information: | © 2022 Springer Nature Switzerland AG. This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Hyponatraemia, Transsphenoidal surgery, Syndrome of Inappropriate ADH secretion, Pituitary adenoma |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10142547 |
Archive Staff Only
 |
View Item |
