HCPLive Network

Hyponatremia Associated with Worse Outcomes Following Cardiac Surgery

 
To study the association between postoperative hyponatremia and mortality, length of hospital stay (LOS), and complications, the authors of “Postoperative Hyponatremia Predicts an Increase in Mortality and In-Hospital Complications after Cardiac Surgery,” published in Journal of the American College of Surgeons, studied outcomes from 4,850 patients who underwent cardiac surgery.
 
They found that 59% of patients experienced postoperative hyponatremia. These patients tended to have lower left ventricle ejection fraction, higher mean pulmonary artery pressures, lower glomerular filtration rate, higher EuroSCORE, and were more likely to be New York Heart Association class IV.
 
Hyponatremic patients in the study also had a higher prevalence of COPD, and peripheral vascular disease.
 
Patients with hyponatremia experienced increased overall and late mortality rates, with mortality rates increasing with the severity of the hyponatremia.
 
They also spent more time in the hospital (average length of stay of 11 days vs. 7 days for non-hyponatremic patients).
 
The authors reported that, after adjusting for baseline and procedure variables, “postoperative hyponatremia was associated with increase in mortality (hazard ratio 1.22, 95% CI 1.06–1.4, p = 0.004), LOS (multiplier 1.34, 95% CI 1.22–1.49, p < 0.001), infectious (odds ratio [OR] 2.32, 95% CI 1.48–3.62, p < 0.001), pulmonary (OR 1.82, 95% CI 1.49–2.21, p < 0.001), and renal failure complications (OR 2.46, 95% CI 1.58–3.81, p < 0.001) and need for dialysis (OR 3.66, 95% CI 1.72–7.79, p = 0.001).
 
Based on these results, the author concluded that “hyponatremia is common after cardiac surgery and is an independent predictor of increased mortality, length of hospital stay, and postoperative complications.”



Further Reading
A study in rats hints that exposure to dim light at night may make human breast cancer tumors resistant to doxorubicin. The study was presented at the American Association for Cancer Research's International Conference on Frontiers in Cancer Prevention Research, held from Sept. 28 to Oct. 1 in New Orleans.
The risk of medical professional liability claims alleging failure to screen for esophageal cancer is not a reason to screen for esophageal cancer, according to a research letter published in the Oct. 1 issue of the Journal of the American Medical Association.
A patient at Texas Health Presbyterian Hospital has tested positive for the deadly virus.
Kevin Skole, MD is a board-certified gastroenterologist practicing in central New Jersey, part of the gastroenterology division of Princeton Healthcare Affiliated Physicians, a multi-specialty medical practice based out of the University Medical Center of Princeton at Plainsboro (see www.princetonhcs.org). He discusses the increased incidence, risk factors, and prevention of Clostridium Difficile (C. diff) infection.
There is a wide variety of evidence to support benefits of low-fat diets versus low carbohydrate diets and vice versa. As of today, no one can tell us with certainty whether the well-worn dictum "calories in calories out" is really true. The National Weight Control Registry data give us some confidence in recommending that to lose weight most people need to alter their diet to reduce calories, and need to exercise on a near-daily basis.
Cannabis users who acknowledge their problem and report withdrawal symptoms are likely to increase abstinence over a 12-month period, according to research published in the Journal of Addiction Medicine.
Device therapy eligibility requirements are underestimated using 2D echocardiography compared to cardiac magnetic resonance imaging, according to a study from the Netherlands Heart Journal.
More Reading