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. 2022 Nov 3;12(1):18622.
doi: 10.1038/s41598-022-23583-1.

Prevalence, risk factors, and potential symptoms of hyponatremia after spinal surgery in elderly patients

Yuki Kinoshita  1 , Koji Tamai  2 , Makoto Oka  1 , Hasibullah Habibi  1 , Hidetomi Terai  1 , Masatoshi Hoshino  1 , Hiromitsu Toyoda  1 , Akinobu Suzuki  1 , Shinji Takahashi  1 , Hiroaki Nakamura  1
Affiliations

Prevalence, risk factors, and potential symptoms of hyponatremia after spinal surgery in elderly patients

Yuki Kinoshita et al. Sci Rep. .

Abstract

Old age and spinal surgery significantly increase the risk of postoperative hyponatremia. However, detailed analyses of postoperative hyponatremia after spinal surgery in elderly patients are lacking. Therefore, we retrospectively reviewed the records of 582 consecutive patients aged > 60 years who underwent spinal surgery to evaluate the frequency, risk factors, and symptoms of postoperative hyponatremia after spinal surgery in the elderly population. Postoperative hyponatremia was defined as a postoperative blood sodium level < 135 meq/L at postoperative day (POD)1, POD3, and/or after POD6. A total of 92 (15.8%) patients showed postoperative hyponatremia. On a multivariate analysis, a diagnosis of a spinal tumor/infection, decompression and fusion surgery, and lower preoperative sodium levels were significant independent factors of postoperative hyponatremia (p = 0.014, 0.009, and < 0.001, respectively). In total, 47/92 (51%) cases could have been symptomatic; vomiting was noted in 34 cases (37%), nausea in 19 cases (21%), headache in 14 cases (15%), and disturbances in consciousness, including delirium, in ten cases (21%); all incidences of these symptoms were significantly higher in elderly patients with postoperative hyponatremia than in the matched control group without postoperative hyponatremia (p < 0.05, respectively). Additionally, the length of stay was 2 days longer in patients than in the matched controls (p = 0.002).

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The timing of postoperative hyponatremia is shown.
See this image and copyright information in PMC

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