Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/2728 |
Resumo: | BACKGROUND: Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS: This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 539 patients undergoing inpatient non-cardiac surgery. Patients were included in this study if they had a recorded value of preoperative serum sodium within the 28 days immediately before surgery. Data describing preoperative risk factors and serum sodium concentrations were analysed to investigate the relationship with in-hospital mortality using univariate and multivariate logistic regression techniques. RESULTS: Of 35 816 (77.0%) patients from the EuSOS database, 21 943 (61.3%) had normal values of serum sodium (138-142 mmol litre(-1)) before surgery, 8538 (23.8%) had hyponatraemia (serum sodium ≤137 mmol litre(-1)) and 5335 (14.9%) had hypernatraemia (serum sodium ≥143 mmol litre(-1)). After adjustment for potential confounding factors, moderate to severe hypernatraemia (serum sodium concentration ≥150 mmol litre(-1)) was independently associated with mortality [odds ratio 3.4 (95% confidence interval 2.0-6.0), P<0.0001]. Hyponatraemia was not associated with mortality. CONCLUSIONS: Preoperative abnormalities in serum sodium concentrations are common, and hypernatraemia is associated with increased mortality after surgery. Abnormalities of serum sodium concentration may be an important biomarker of perioperative risk resulting from co-morbid disease. |
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Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major SurgeryAgedComorbidityEuropeFemaleHumansHypernatremiaHyponatremiaIntensive Care UnitsMaleMiddle AgedOdds RatioPostoperative ComplicationsProspective StudiesRetrospective StudiesRisk FactorsSodiumSurgical Procedures, OperativeHospital MortalityPreoperative PeriodHSJ UCIBACKGROUND: Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS: This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 539 patients undergoing inpatient non-cardiac surgery. Patients were included in this study if they had a recorded value of preoperative serum sodium within the 28 days immediately before surgery. Data describing preoperative risk factors and serum sodium concentrations were analysed to investigate the relationship with in-hospital mortality using univariate and multivariate logistic regression techniques. RESULTS: Of 35 816 (77.0%) patients from the EuSOS database, 21 943 (61.3%) had normal values of serum sodium (138-142 mmol litre(-1)) before surgery, 8538 (23.8%) had hyponatraemia (serum sodium ≤137 mmol litre(-1)) and 5335 (14.9%) had hypernatraemia (serum sodium ≥143 mmol litre(-1)). After adjustment for potential confounding factors, moderate to severe hypernatraemia (serum sodium concentration ≥150 mmol litre(-1)) was independently associated with mortality [odds ratio 3.4 (95% confidence interval 2.0-6.0), P<0.0001]. Hyponatraemia was not associated with mortality. CONCLUSIONS: Preoperative abnormalities in serum sodium concentrations are common, and hypernatraemia is associated with increased mortality after surgery. Abnormalities of serum sodium concentration may be an important biomarker of perioperative risk resulting from co-morbid disease.Oxford University PressRepositório do Centro Hospitalar Universitário de Lisboa Central, EPECecconi, MHochrieser, HChew, MGrocott, MHoeft, AHoste, AJammer, IPosch, MMetnitz, PPelosi, PMoreno, RPearse, RMVincent, JLRhodes, A2017-07-20T14:55:23Z2016-012016-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/2728engBr J Anaesth. 2016 Jan;116(1):63-910.1093/bja/aev373info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:39:21Zoai:repositorio.chlc.min-saude.pt:10400.17/2728Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:03.830669Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery |
title |
Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery |
spellingShingle |
Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery Cecconi, M Aged Comorbidity Europe Female Humans Hypernatremia Hyponatremia Intensive Care Units Male Middle Aged Odds Ratio Postoperative Complications Prospective Studies Retrospective Studies Risk Factors Sodium Surgical Procedures, Operative Hospital Mortality Preoperative Period HSJ UCI |
title_short |
Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery |
title_full |
Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery |
title_fullStr |
Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery |
title_full_unstemmed |
Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery |
title_sort |
Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery |
author |
Cecconi, M |
author_facet |
Cecconi, M Hochrieser, H Chew, M Grocott, M Hoeft, A Hoste, A Jammer, I Posch, M Metnitz, P Pelosi, P Moreno, R Pearse, RM Vincent, JL Rhodes, A |
author_role |
author |
author2 |
Hochrieser, H Chew, M Grocott, M Hoeft, A Hoste, A Jammer, I Posch, M Metnitz, P Pelosi, P Moreno, R Pearse, RM Vincent, JL Rhodes, A |
author2_role |
author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Cecconi, M Hochrieser, H Chew, M Grocott, M Hoeft, A Hoste, A Jammer, I Posch, M Metnitz, P Pelosi, P Moreno, R Pearse, RM Vincent, JL Rhodes, A |
dc.subject.por.fl_str_mv |
Aged Comorbidity Europe Female Humans Hypernatremia Hyponatremia Intensive Care Units Male Middle Aged Odds Ratio Postoperative Complications Prospective Studies Retrospective Studies Risk Factors Sodium Surgical Procedures, Operative Hospital Mortality Preoperative Period HSJ UCI |
topic |
Aged Comorbidity Europe Female Humans Hypernatremia Hyponatremia Intensive Care Units Male Middle Aged Odds Ratio Postoperative Complications Prospective Studies Retrospective Studies Risk Factors Sodium Surgical Procedures, Operative Hospital Mortality Preoperative Period HSJ UCI |
description |
BACKGROUND: Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS: This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 539 patients undergoing inpatient non-cardiac surgery. Patients were included in this study if they had a recorded value of preoperative serum sodium within the 28 days immediately before surgery. Data describing preoperative risk factors and serum sodium concentrations were analysed to investigate the relationship with in-hospital mortality using univariate and multivariate logistic regression techniques. RESULTS: Of 35 816 (77.0%) patients from the EuSOS database, 21 943 (61.3%) had normal values of serum sodium (138-142 mmol litre(-1)) before surgery, 8538 (23.8%) had hyponatraemia (serum sodium ≤137 mmol litre(-1)) and 5335 (14.9%) had hypernatraemia (serum sodium ≥143 mmol litre(-1)). After adjustment for potential confounding factors, moderate to severe hypernatraemia (serum sodium concentration ≥150 mmol litre(-1)) was independently associated with mortality [odds ratio 3.4 (95% confidence interval 2.0-6.0), P<0.0001]. Hyponatraemia was not associated with mortality. CONCLUSIONS: Preoperative abnormalities in serum sodium concentrations are common, and hypernatraemia is associated with increased mortality after surgery. Abnormalities of serum sodium concentration may be an important biomarker of perioperative risk resulting from co-morbid disease. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-01 2016-01-01T00:00:00Z 2017-07-20T14:55:23Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/2728 |
url |
http://hdl.handle.net/10400.17/2728 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Br J Anaesth. 2016 Jan;116(1):63-9 10.1093/bja/aev373 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Oxford University Press |
publisher.none.fl_str_mv |
Oxford University Press |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131297010941952 |