PDF(Pubmed)
Abstract：
UNASSIGNED: The incidence of hyponatremia after orthopedic surgery is high. Hyponatremia may prolong hospitalization and increase mortality, but few reports have identified risk factors for hyponatremia after spinal surgery. This study aims to determine the incidence and risk factors for hyponatremia after spinal surgery.
UNASSIGNED: A total of 200 patients aged 20 years or older who underwent spinal surgery at our hospital from 2020-2021 were recruited. Data on age, sex, height, weight, body mass index, operation duration, blood loss, albumin level, the geriatric nutritional risk index (GNRI), potassium level, the estimated glomerular filtration rate (eGFR), sodium level, length of hospital stay, history of hypertension, dialysis status, the occurrence of delirium during hospital stay, and oral medication use were collected. Comparisons between the postoperative hyponatremia group and the postoperative normonatremia group were conducted to evaluate the impact of hyponatremia on clinical outcomes.
UNASSIGNED: Postoperative hyponatremia was observed in 56 (28%) of the 200 patients after spinal surgery. Comparison between the postoperative hyponatremia group with the postoperative normonatremia group revealed that the patients in the postoperative hyponatremia group were significantly older (72 versus 68.5 years, p<0.01). Postoperative hyponatremia was significantly associated with low GNRI values (100.8 versus 109.3, p<0.01), low eGFR values (59.2 versus 70.8 mL/min/1.73 m2, p<0.01), preoperative hyponatremia (138.5 vs. 141 mEq/L, p<0.01), and a high incidence of delirium (12.5% versus 2.7%, p=0.01). Older age (odds ratio=1.04, p=0.01) and preoperative hyponatremia (odds ratio=0.66, p value<0.01) were risk factors for postoperative hyponatremia.
UNASSIGNED: In addition to older age and preoperative hyponatremia, the study identified new risk factors for postoperative hyponatremia, which are preoperative undernutrition and impaired renal function. The incidence of delirium was significantly higher in the postoperative hyponatremia group, suggesting that correcting preoperative hyponatremia and ensuring good nutrition may prevent delirium and thereby shorten hospital stays.
UNASSIGNED: A total of 200 patients aged 20 years or older who underwent spinal surgery at our hospital from 2020-2021 were recruited. Data on age, sex, height, weight, body mass index, operation duration, blood loss, albumin level, the geriatric nutritional risk index (GNRI), potassium level, the estimated glomerular filtration rate (eGFR), sodium level, length of hospital stay, history of hypertension, dialysis status, the occurrence of delirium during hospital stay, and oral medication use were collected. Comparisons between the postoperative hyponatremia group and the postoperative normonatremia group were conducted to evaluate the impact of hyponatremia on clinical outcomes.
UNASSIGNED: Postoperative hyponatremia was observed in 56 (28%) of the 200 patients after spinal surgery. Comparison between the postoperative hyponatremia group with the postoperative normonatremia group revealed that the patients in the postoperative hyponatremia group were significantly older (72 versus 68.5 years, p<0.01). Postoperative hyponatremia was significantly associated with low GNRI values (100.8 versus 109.3, p<0.01), low eGFR values (59.2 versus 70.8 mL/min/1.73 m2, p<0.01), preoperative hyponatremia (138.5 vs. 141 mEq/L, p<0.01), and a high incidence of delirium (12.5% versus 2.7%, p=0.01). Older age (odds ratio=1.04, p=0.01) and preoperative hyponatremia (odds ratio=0.66, p value<0.01) were risk factors for postoperative hyponatremia.
UNASSIGNED: In addition to older age and preoperative hyponatremia, the study identified new risk factors for postoperative hyponatremia, which are preoperative undernutrition and impaired renal function. The incidence of delirium was significantly higher in the postoperative hyponatremia group, suggesting that correcting preoperative hyponatremia and ensuring good nutrition may prevent delirium and thereby shorten hospital stays.
摘要：
■骨科手术后低钠血症的发生率很高。低钠血症可能延长住院时间，增加死亡率，但很少有报告确定脊柱手术后低钠血症的危险因素。这项研究旨在确定脊柱手术后低钠血症的发生率和危险因素。
■招募了从2020年至2021年在我们医院接受脊柱手术的200名年龄在20岁或以上的患者。年龄数据,性别,高度,体重,身体质量指数,操作持续时间,失血,白蛋白水平,老年营养风险指数(GNRI)，钾水平，估计的肾小球滤过率(eGFR)，钠水平，住院时间,高血压病史,透析状态,住院期间谵妄的发生，收集口服药物使用情况。比较术后低钠血症组与术后正常血症组,评价低钠血症对临床结局的影响。
■脊柱手术后200例患者中有56例（28％）出现术后低钠血症。术后低钠血症组与术后低钠血症组之间的比较显示，术后低钠血症组患者明显年龄较大（72岁对68.5岁，p<0.01)。术后低钠血症与低GNRI值显著相关(100.8对109.3,p<0.01),低eGFR值（59.2对70.8mL/min/1.73m2，p<0.01），术前低钠血症（138.5vs.141mEq/L，p<0.01),谵妄发生率很高(12.5%对2.7%，p=0.01)。高龄(比值比=1.04,p=0.01)和术前低钠血症(比值比=0.66,p值<0.01)是术后低钠血症的危险因素。
■除了年龄较大和术前低钠血症，这项研究发现了术后低钠血症的新危险因素，术前营养不良和肾功能受损。术后低钠血症组谵妄发生率明显增高,提示纠正术前低钠血症和确保良好的营养可以预防谵妄，从而缩短住院时间。
■招募了从2020年至2021年在我们医院接受脊柱手术的200名年龄在20岁或以上的患者。年龄数据,性别,高度,体重,身体质量指数,操作持续时间,失血,白蛋白水平,老年营养风险指数(GNRI)，钾水平，估计的肾小球滤过率(eGFR)，钠水平，住院时间,高血压病史,透析状态,住院期间谵妄的发生，收集口服药物使用情况。比较术后低钠血症组与术后正常血症组,评价低钠血症对临床结局的影响。
■脊柱手术后200例患者中有56例（28％）出现术后低钠血症。术后低钠血症组与术后低钠血症组之间的比较显示，术后低钠血症组患者明显年龄较大（72岁对68.5岁，p<0.01)。术后低钠血症与低GNRI值显著相关(100.8对109.3,p<0.01),低eGFR值（59.2对70.8mL/min/1.73m2，p<0.01），术前低钠血症（138.5vs.141mEq/L，p<0.01),谵妄发生率很高(12.5%对2.7%，p=0.01)。高龄(比值比=1.04,p=0.01)和术前低钠血症(比值比=0.66,p值<0.01)是术后低钠血症的危险因素。
■除了年龄较大和术前低钠血症，这项研究发现了术后低钠血症的新危险因素，术前营养不良和肾功能受损。术后低钠血症组谵妄发生率明显增高,提示纠正术前低钠血症和确保良好的营养可以预防谵妄，从而缩短住院时间。
