Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients.

Hdl Handle:
http://hdl.handle.net/10147/127605
Title:
Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients.
Authors:
Sherlock, M; O'Sullivan, E; Agha, A; Behan, L A; Owens, D; Finucane, F; Rawluk, D; Tormey, W; Thompson, C J
Affiliation:
Department of Academic Endocrinology, Beaumont Hospital, Dublin, Ireland.
Citation:
Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients. 2009, 85 (1002):171-5 Postgrad Med J
Journal:
Postgraduate medical journal
Issue Date:
Apr-2009
URI:
http://hdl.handle.net/10147/127605
DOI:
10.1136/pgmj.2008.072819
PubMed ID:
19417163
Abstract:
Hyponatraemia is a well-recognised complication of neurosurgical conditions, but the incidence and implications have not been well documented.; To define the incidence, pathophysiology and clinical implications of significant hyponatraemia in several neurosurgical conditions.; All patients admitted to the Irish National Neurosciences Centre at Beaumont Hospital, Dublin with traumatic brain injury, subarachnoid haemorrhage, intracranial neoplasm, pituitary disorders and spinal disorders who developed significant hyponatraemia (plasma sodium <130 mmol/l) from January 2002 to September 2003 were identified from computerised laboratory records. Data were collected by retrospective case note analysis.; Hyponatraemia was more common in patients with pituitary disorders (5/81, 6.25%; p = 0.004), traumatic brain injury (44/457, 9.6%; p<0.001), intracranial neoplasm (56/355, 15.8%; p<0.001) and subarachnoid haemorrhage (62/316, 19.6%; p<0.001) than in those with spinal disorders (4/489, 0.81%). The pathophysiology of hyponatraemia was: syndrome of inappropriate antidiuretic hormone secretion (SIADH) in 116 cases (62%) (31 (16.6%) drug-associated), hypovolaemic hyponatraemia in 50 cases (26.7%) (which included patients with insufficient data to assign to the cerebral salt-wasting group (CSWS)), CSWS in nine cases (4.8%), intravenous fluids in seven cases (3.7%) and mixed SIADH/CSWS in five cases (2.7%). Hyponatraemic patients with cerebral irritation had significantly lower plasma sodium concentrations (mean (SD) 124.8 (0.34) mmol/l) than asymptomatic patients (126.6 (0.29) mmol/l) (p<0.0001). Hyponatraemic patients had a significantly longer hospital stay (median 19 days (interquartile range (IQR) 12-28)) than normonatraemic patients (median 12 days (IQR 10.5-15)) (p<0.001).; Hyponatraemia is common in intracerebral disorders and is associated with a longer hospital stay. Cerebral irritation is associated with more severe hyponatraemia. SIADH is the most common cause of hyponatraemia and is often drug-associated.
Item Type:
Article
Language:
en
MeSH:
Adult; Aged; Central Nervous System Diseases; Female; Humans; Hyponatremia; Inappropriate ADH Syndrome; Male; Middle Aged; Neurosurgical Procedures
ISSN:
1469-0756

Full metadata record

DC FieldValue Language
dc.contributor.authorSherlock, Men
dc.contributor.authorO'Sullivan, Een
dc.contributor.authorAgha, Aen
dc.contributor.authorBehan, L Aen
dc.contributor.authorOwens, Den
dc.contributor.authorFinucane, Fen
dc.contributor.authorRawluk, Den
dc.contributor.authorTormey, Wen
dc.contributor.authorThompson, C Jen
dc.date.accessioned2011-04-07T07:59:52Z-
dc.date.available2011-04-07T07:59:52Z-
dc.date.issued2009-04-
dc.identifier.citationIncidence and pathophysiology of severe hyponatraemia in neurosurgical patients. 2009, 85 (1002):171-5 Postgrad Med Jen
dc.identifier.issn1469-0756-
dc.identifier.pmid19417163-
dc.identifier.doi10.1136/pgmj.2008.072819-
dc.identifier.urihttp://hdl.handle.net/10147/127605-
dc.description.abstractHyponatraemia is a well-recognised complication of neurosurgical conditions, but the incidence and implications have not been well documented.-
dc.description.abstractTo define the incidence, pathophysiology and clinical implications of significant hyponatraemia in several neurosurgical conditions.-
dc.description.abstractAll patients admitted to the Irish National Neurosciences Centre at Beaumont Hospital, Dublin with traumatic brain injury, subarachnoid haemorrhage, intracranial neoplasm, pituitary disorders and spinal disorders who developed significant hyponatraemia (plasma sodium <130 mmol/l) from January 2002 to September 2003 were identified from computerised laboratory records. Data were collected by retrospective case note analysis.-
dc.description.abstractHyponatraemia was more common in patients with pituitary disorders (5/81, 6.25%; p = 0.004), traumatic brain injury (44/457, 9.6%; p<0.001), intracranial neoplasm (56/355, 15.8%; p<0.001) and subarachnoid haemorrhage (62/316, 19.6%; p<0.001) than in those with spinal disorders (4/489, 0.81%). The pathophysiology of hyponatraemia was: syndrome of inappropriate antidiuretic hormone secretion (SIADH) in 116 cases (62%) (31 (16.6%) drug-associated), hypovolaemic hyponatraemia in 50 cases (26.7%) (which included patients with insufficient data to assign to the cerebral salt-wasting group (CSWS)), CSWS in nine cases (4.8%), intravenous fluids in seven cases (3.7%) and mixed SIADH/CSWS in five cases (2.7%). Hyponatraemic patients with cerebral irritation had significantly lower plasma sodium concentrations (mean (SD) 124.8 (0.34) mmol/l) than asymptomatic patients (126.6 (0.29) mmol/l) (p<0.0001). Hyponatraemic patients had a significantly longer hospital stay (median 19 days (interquartile range (IQR) 12-28)) than normonatraemic patients (median 12 days (IQR 10.5-15)) (p<0.001).-
dc.description.abstractHyponatraemia is common in intracerebral disorders and is associated with a longer hospital stay. Cerebral irritation is associated with more severe hyponatraemia. SIADH is the most common cause of hyponatraemia and is often drug-associated.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshCentral Nervous System Diseases-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshHyponatremia-
dc.subject.meshInappropriate ADH Syndrome-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshNeurosurgical Procedures-
dc.titleIncidence and pathophysiology of severe hyponatraemia in neurosurgical patients.en
dc.typeArticleen
dc.contributor.departmentDepartment of Academic Endocrinology, Beaumont Hospital, Dublin, Ireland.en
dc.identifier.journalPostgraduate medical journalen
dc.description.provinceLeinster-

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