The Role of Hyponatraemia Before Surgery in Patients With Radical Resected Pancreatic Cancer

Berardi, Rossana; Rinaldi, Silvia; Belfiori, Giulio; Partelli, Stefano; Crippa, Stefano; Torniai, Mariangela; Falconi, Massimo

doi:10.1177/1179554920936605

Cited by 5 publications

(2 citation statements)

References 57 publications

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“…Twelve studies included patients who underwent orthopedic surgeries ( 16 , 18 , 24 , 27 , 32 , 33 , 35 , 38 , 41-43 , 45 ); 10 studies involved patients who underwent liver transplantation ( 5 , 7 , 26 , 29 , 31 , 36 , 39 , 40 , 46 , 48 ); 4 studies for cardiac surgical procedures ( 17 , 28 , 37 , 44 ); 3 studies on surgeries of multiple disciplines ( 9 , 14 , 30 ); and 1 study each on radical gastrectomy ( 47 ), surgical procedures for epithelial ovarian cancer ( 34 ), and radical surgical procedures for pancreatic ductal adenocarcinoma ( 25 ). Sixteen studies included patients from North America ( 5 , 7 , 14 , 16-18 , 27 , 28 , 30 , 32 , 35 , 37-39 , 42 , 43 ), 8 studies from Europe ( 9 , 25 , 29 , 34 , 36 , 40 , 41 , 45 ), 5 from Asia ( 31 , 33 , 46-48 ), 2 from South America ( 24 , 26 ), and 1 from Israel ( …”

Section: Resultsmentioning

confidence: 99%

“…Twenty-two studies defined hyponatremia as serum sodium levels of either < or ≤135 mEq/L ( 5 , 14 , 16-18 , 24 , 25 , 28-30 , 32-35 , 37 , 38 , 41-46 ), 8 defined hyponatremia as either < or ≤130 mEq/L ( 7 , 26 , 31 , 36 , 39 , 40 , 47 , 48 ), 1 study used the cut off of ≤137 mEq/L to define hyponatremia ( 9 ), and 1 study did not specify the numerical definition of hyponatremia ( 27 ). Three of the studies reported outcomes stratified by the degree of severity of hyponatremia of patients ( 9 , 16 , 29 ).…”

Section: Resultsmentioning

confidence: 99%

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

Teo

Gan

Tay

et al. 2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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Background Preoperative hyponatremia is prevalent in patients undergoing surgical procedures, but it is uncertain if hyponatremia will lead to increased risk of surgical mortality and morbidity. Methods A systematic search of Medline (PubMed), Embase and Cochrane Library from inception till 2 July 2021 was performed. Full length articles that reported on the association between surgical outcomes among adults ≥18 years with documented preoperative hyponatremia were included. Findings We identified 32 observational studies comprising 1,301,346 participants. All studies had low risk of bias. When adjusted for covariates, patients with hyponatremia had significantly higher odds of developing major complications (defined as a composite measure of 9 major complications) compared to patients with normal sodium concentrations (aOR = 1.37, 95%CI = 1.23-1.53, I2 = 78%. N = 10). Additionally, patients with preoperative hyponatremia also significantly higher hazards of early mortality (<90 days) compared to patients with normonatremia (aHR = 1.27, 95%CI = 1.13-1.43, I2 = 97%. N = 10) after adjustment for covariates. Preoperative hyponatremia also had significant associations with respiratory, renal and septic complications. In terms of prognostic performance, preoperative hyponatremia performed adequately in predicting major complications in surgical patients (AUC = 0.70, LR- 0.90) with a specificity of 88% and a sensitivity of 25%. Interpretation Our meta-analysis suggests that preoperative hyponatremia is associated with poorer early mortality and major morbidity outcomes in surgical patients. Hyponatremia is also a specific prognosticator for major complications in surgical patients, reiterating its potential use as a clinical indicator of poor outcomes.

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