Abstract：
BACKGROUND: Patients are commonly monitored for hyponatremia after intracranial procedures, yet the prevalence of hyponatremia after cranial vault reconstruction (CVR) remains unclear. The purpose of this study is to define the prevalence, risk factors, and complications of hyponatremia after CVR to optimize postoperative sodium surveillance protocols.
METHODS: Patients with nonsyndromic, single-suture craniosynostosis who underwent primary CVR between 2009 and 2020 at Michigan Medicine were included (n = 231). Demographic, intraoperative, and postoperative characteristics were compared by postoperative hyponatremia status at P < 0.05 significance. Hyponatremia was defined as mild (<135 mEq/L), moderate (<130 mEq/L), or severe (<125 mEq/L) based on the lowest postoperative laboratory draw.
RESULTS: Twenty-three patients (10.0%) developed mild postoperative hyponatremia. No patient developed moderate or severe postoperative hyponatremia. On multivariable regression, decreased preoperative sodium level (P = 0.03) and decreased preoperative weight (P = 0.02) were significantly associated with mild postoperative hyponatremia. No patient developed complications or required hospital readmission because of hyponatremia.
CONCLUSIONS: This large retrospective cohort study of patients with nonsyndromic single-suture craniosynostosis demonstrated a 10% prevalence of mild, clinically inconsequential hyponatremia and 0% prevalence of moderate or severe, clinically significant hyponatremia after primary CVR. Patients with low preoperative sodium level or weight were at increased risk for developing mild postoperative hyponatremia. The results suggest that patients with preoperative sodium greater than 140 mEq/L or preoperative weight greater than 10 kg may be candidates for limited postoperative sodium surveillance; however, future prospective studies are warranted before implementation.
METHODS: Risk, III.
METHODS: Patients with nonsyndromic, single-suture craniosynostosis who underwent primary CVR between 2009 and 2020 at Michigan Medicine were included (n = 231). Demographic, intraoperative, and postoperative characteristics were compared by postoperative hyponatremia status at P < 0.05 significance. Hyponatremia was defined as mild (<135 mEq/L), moderate (<130 mEq/L), or severe (<125 mEq/L) based on the lowest postoperative laboratory draw.
RESULTS: Twenty-three patients (10.0%) developed mild postoperative hyponatremia. No patient developed moderate or severe postoperative hyponatremia. On multivariable regression, decreased preoperative sodium level (P = 0.03) and decreased preoperative weight (P = 0.02) were significantly associated with mild postoperative hyponatremia. No patient developed complications or required hospital readmission because of hyponatremia.
CONCLUSIONS: This large retrospective cohort study of patients with nonsyndromic single-suture craniosynostosis demonstrated a 10% prevalence of mild, clinically inconsequential hyponatremia and 0% prevalence of moderate or severe, clinically significant hyponatremia after primary CVR. Patients with low preoperative sodium level or weight were at increased risk for developing mild postoperative hyponatremia. The results suggest that patients with preoperative sodium greater than 140 mEq/L or preoperative weight greater than 10 kg may be candidates for limited postoperative sodium surveillance; however, future prospective studies are warranted before implementation.
METHODS: Risk, III.
摘要：
背景：患者通常在颅内手术后监测低钠血症，然而,颅部重建(CVR)后低钠血症的发生率尚不清楚.这项研究的目的是定义患病率，危险因素，CVR后低钠血症的并发症，以优化术后钠监测方案。
方法：非综合征患者，纳入2009年至2020年在密歇根医学院接受原发性CVR的单缝线颅骨融合(n=231).人口统计,术中,与术后特点比较,术后低钠血症状态P<0.05有显著性意义。低钠血症定义为轻度（<135mEq/L），中等（<130mEq/L），或严重（<125mEq/L），基于最低的术后实验室抽取。
结果：23例患者（10.0%）术后出现轻度低钠血症。术后无患者出现中度或重度低钠血症。在多元回归中，术前钠水平降低(P=0.03)和术前体重降低(P=0.02)与轻度术后低钠血症显著相关.没有患者因低钠血症而出现并发症或需要再次住院。
结论：这项针对非综合征性单缝颅骨融合症患者的大型回顾性队列研究表明，轻度，临床上无关紧要的低钠血症和0%的中度或重度患病率，原发性CVR后临床显着低钠血症。术前钠水平或体重较低的患者发生轻度低钠血症的风险增加。结果表明，术前钠大于140mEq/L或体重大于10kg的患者可能是术后钠监测有限的候选人；然而，未来的前瞻性研究在实施之前是有必要的.
方法：风险，III.
方法：非综合征患者，纳入2009年至2020年在密歇根医学院接受原发性CVR的单缝线颅骨融合(n=231).人口统计,术中,与术后特点比较,术后低钠血症状态P<0.05有显著性意义。低钠血症定义为轻度（<135mEq/L），中等（<130mEq/L），或严重（<125mEq/L），基于最低的术后实验室抽取。
结果：23例患者（10.0%）术后出现轻度低钠血症。术后无患者出现中度或重度低钠血症。在多元回归中，术前钠水平降低(P=0.03)和术前体重降低(P=0.02)与轻度术后低钠血症显著相关.没有患者因低钠血症而出现并发症或需要再次住院。
结论：这项针对非综合征性单缝颅骨融合症患者的大型回顾性队列研究表明，轻度，临床上无关紧要的低钠血症和0%的中度或重度患病率，原发性CVR后临床显着低钠血症。术前钠水平或体重较低的患者发生轻度低钠血症的风险增加。结果表明，术前钠大于140mEq/L或体重大于10kg的患者可能是术后钠监测有限的候选人；然而，未来的前瞻性研究在实施之前是有必要的.
方法：风险，III.
