Association of Preoperative Hyponatremia With Surgical Outcomes: A Systematic Review and Meta-analysis of 32 Observational Studies

Teo, Chung‐Piaw; Gan, Ming Yi; Tay, Ryan Yong Kiat; Loh, Wann Jia; Loh, Ne-Hooi Will

doi:10.1210/clinem/dgac685

Cited by 4 publications

(2 citation statements)

References 66 publications

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“…Furthermore, this study showed an increase in several adverse outcomes with thiazide use, in concordance with several previous studies that reported an association of hyponatremia with poor clinical outcomes 24–27 . The in‐depth analyzes such as multivariate analysis were not performed about other outcomes other than the occurrence of hyponatremia, so that a causal relationship could not be claimed.…”

Section: Discussionsupporting

confidence: 88%

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Thiazide‐associated hyponatremia in arterial hypertension patients: A nationwide population‐based cohort study

Kwon,

Kim,

Lee

et al. 2024

J Evidence Based Medicine

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ObjectiveThiazides are the first‐line treatment for hypertension, however, they have been associated with hospitalizations for thiazide‐associated hyponatremia (TAH). The aim of this study was to evaluate the risk of TAH and other drug‐associated hyponatremia in a Korean population.MethodsThe study used big data from the National Health Insurance Sharing Service of 1,943,345 adults treated for hypertension from January 2014 to December 2016. The participants were divided into two groups based on the use of thiazides. Cox proportional hazard models were used to identify independent risk factors for the occurrence of hyponatremia.ResultsThe study found that hyponatremia‐related hospitalizations were significantly higher in the thiazide group than the control group (2.19% vs. 1.45%). The risk increased further with concurrent use of other diuretics or desmopressin, and thiazide+spironolactone+desmopressin and hospitalization risk further increased (4.0 and 6.9 times). Multivariate analysis showed that hyponatremia occurrence increased with age, diabetes mellitus, depression, and thiazide use (hazard ratio = 1.436, p < 0.001). The thiazide group had better 6‐year overall survival than the control group but had more fractures and hyponatremia.ConclusionsThiazide use is associated with an increased risk of hyponatremia and related complications. However, the mortality rate decreased in those who received thiazides, suggesting that thiazide use itself is not harmful and may help decrease complications and improve prognosis with proper, cautious use in high‐risk patients.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Thiazide‐associated hyponatremia in arterial hypertension patients: A nationwide population‐based cohort study

Kwon,

Kim,

Lee

et al. 2024

J Evidence Based Medicine

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Risk of Hyponatremia after Tramadol/Acetaminophen Single-Pill Combination Therapy: A Real-World Study Based on the OMOP–CDM Database

Lee

Kim

Han³

et al. 2023

Drugs R D

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Background and Objective Tramadol has been reported to cause hyponatremia but the evidence is conflicting. The risk of hyponatremia resulting from combination oral tramadol/acetaminophen (TA) therapy is thus unknown. This study examined whether, compared with acetaminophen (AA), TA use is associated with an increased risk of hyponatremia. Methods Hospital data compatible with the Observational Medical Outcomes Partnership–Common Data Model (OMOP–CDM; version 5.3) for 30,999 patients taking TA or AA from 2011 through 2020 were analyzed. New-onset hyponatremia was defined as a serum sodium level < 135 mEq/L within 10 days after drug initiation. The incidence rate ratio was calculated based on crude and 1:1 propensity-score-matched models. Subgroup analyses compared patients taking TA extended-release (TA–ER) and TA immediate-release (TA–IR) formulations. Results Among the 30,999 patients, 12,122 (39.1%) were aged > 65 years and 16,654 (53.7%) were male. Hyponatremia within 10 days developed in 1613 (8.4%) of the 19,149 patients in the TA group; the incidence rate was higher than in the AA group (4.2%; 493 out of 11,850 cases). In the propensity-score-matched model, the incidence rate of hyponatremia in the TA group was 6.8 per 1000 person-days (PD), which was 1.57-fold (1.31, 1.89) higher than that in the AA group (4.3 per 1000 PD). In both the crude and propensity-score-matched models, the incidence rate of hyponatremia was significantly higher in the TA–ER than TA–IR subgroup. Conclusion In this real-world study, hyponatremia was more frequently observed in the TA than AA group, and in the TA–ER than TA–IR subgroup. Therefore, it is imperative to prescribe tramadol cautiously and closely monitor electrolyte levels. Supplementary Information The online version contains supplementary material available at 10.1007/s40268-023-00436-4.

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Rapidly progressive necrotizing enterocolitis: Risk factors and a predictive model

Li,

Zhou,

Weng

et al. 2024

Pediatr Res

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Association of Preoperative Hyponatremia With Surgical Outcomes: A Systematic Review and Meta-analysis of 32 Observational Studies

Cited by 4 publications

References 66 publications

Thiazide‐associated hyponatremia in arterial hypertension patients: A nationwide population‐based cohort study

Thiazide‐associated hyponatremia in arterial hypertension patients: A nationwide population‐based cohort study

Risk of Hyponatremia after Tramadol/Acetaminophen Single-Pill Combination Therapy: A Real-World Study Based on the OMOP–CDM Database

Rapidly progressive necrotizing enterocolitis: Risk factors and a predictive model

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