Highs and Lows: Dysnatremia and Patient Outcomes in Aneurysmal Subarachnoid Hemorrhage

Disturbances in serum sodium concentration (dysnatremia) are common following aneurysmal subarachnoid hemorrhage (aSAH), but its direct impact on outcomes is not well understood. This study aimed to examine the association between dysnatremia following aSAH and patient outcomes. A retrospective coho...

Full description

Saved in:
Bibliographic Details
Published in:World neurosurgery 2023-05, Vol.173, p.e298-e305
Main Authors: Helliwell, Alexandra, Snow, Ryan, Wendell, Linda C., Thompson, Bradford B., Reznik, Michael E., Furie, Karen L., Mahta, Ali
Format: Article
Language:English
Subjects:
Aneurysm
Dysnatremia
Female
Humans
Hypernatremia
Hyponatremia
Hyponatremia - complications
Length of stay
Male
Middle Aged
Outcome
Retrospective Studies
Sodium
Subarachnoid hemorrhage
Subarachnoid Hemorrhage - complications
Subarachnoid Hemorrhage - therapy
Vasospasm, Intracranial - complications
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Disturbances in serum sodium concentration (dysnatremia) are common following aneurysmal subarachnoid hemorrhage (aSAH), but its direct impact on outcomes is not well understood. This study aimed to examine the association between dysnatremia following aSAH and patient outcomes. A retrospective cohort study of consecutive patients with aSAH who were admitted to an academic referral center between 2015 and 2021 was performed. Multivariate logistic regression was used to test the association of dysnatremia and outcomes including modified Rankin Scale score at 3 months after discharge and vasospasm. Multiple linear regression was used to test the association of hospital length of stay and dysnatremia. We included 320 patients with confirmed aneurysmal etiology (mean [SD] age = 57.8 [14.3] years; 61% female; 70% White). No independent associations were found between hyponatremia or hypernatremia and functional outcome or vasospasm. However, hospital length of stay was longer in patients with hypernatremia (7 more days; 95% confidence interval = 4.4–9.6, P < 0.001) independent of age, Hunt and Hess grade, modified Fisher score, delayed cerebral ischemia, and other hospital complications. Although dysnatremia may not directly impact functional outcome or vasospasm risk, hypernatremia may prolong hospital length of stay. Judicious use of hypertonic saline solutions and avoidance of unnecessary dysnatremia in patients with aSAH should be considered.
ISSN:1878-8750
1878-8769
1878-8769
DOI:10.1016/j.wneu.2023.02.043