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dc.contributor.authorKlinck, Jen
dc.contributor.authorMcNeill, Len
dc.contributor.authorDi, Angelantonio Een
dc.contributor.authorMenon, Daviden
dc.date.accessioned2014-09-30T14:17:49Z
dc.date.available2014-09-30T14:17:49Z
dc.date.issued2014en
dc.identifier.citationKlink et al. The British Journal of Anaesthesia (2014) Vol. 114, Issue 4, pp. 615-622. DOI: 10.1093/bja/aeu409en
dc.identifier.issn0007-0912
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/246085
dc.description.abstractBACKGROUND: The perioperative period may be associated with a marked neurohumoral stress response, significant fluid losses and varied fluid replacement regimes. Acute changes in serum sodium concentration are therefore common, but predictors and outcomes of these changes have not been investigated in a large surgical population. METHODS: We carried out a retrospective cohort analysis of 27,068 in-patient non-cardiac surgical procedures in a tertiary teaching hospital setting. Data on preoperative conditions, perioperative events, hospital length of stay and mortality were collected, along with preoperative and postoperative serum sodium measurements up to seven days after surgery. Logistic regression was used to investigate the association between sodium changes and mortality, and to identify clinical characteristics associated with a deviation from baseline sodium greater than 5 mmol/l. RESULTS: Changes in sodium concentration > 5mmol/l were associated with increased mortality risk (adjusted OR 1.49 for a decrease, 3.02 for an increase). Factors independently associated with a perioperative decrease in serum sodium concentration >5 mmol/l included age >60, diabetes mellitus and use of patient-controlled opioid analgesia. Factors associated with a similar increase were preoperative oxygen dependency, mechanical ventilation, central nervous system depression, non-elective surgery and major operative hemorrhage. CONCLUSIONS: Maximum deviation from preoperative serum sodium value is associated with increased hospital mortality in patients undergoing in-patient non-cardiac surgery. Specific preoperative and perioperative factors are associated with significant serum sodium changes.
dc.description.sponsorshipThis work was supported by the Cambridge University Division of Anaesthesia.
dc.languageEnglishen
dc.language.isoenen
dc.publisherOxford Journals on behalf of the British Journal of Anaesthesia
dc.subjectHospital Mortalityen
dc.subjectPerioperative Perioden
dc.subjectSodiumen
dc.titlePredictors and outcome impact of perioperative serum sodium changes in a high risk populationen
dc.typeArticle
dc.description.versionThis is the author accepted manuscript. The final version is available from Oxford University Press via http://dx.doi.org/10.1093/bja/aeu409en
prism.endingPage622
prism.publicationDate2014en
prism.publicationNameBritish Journal of Anaesthesiaen
prism.startingPage615
prism.volume114en
rioxxterms.versionofrecord10.1093/bja/aeu409en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2014en
dc.contributor.orcidMenon, David [0000-0002-3228-9692]
dc.identifier.eissn1471-6771
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idMEDICAL RESEARCH COUNCIL (G0001354)
pubs.funder-project-idMRC (MR/L003120/1)
pubs.funder-project-idBritish Heart Foundation (RG/08/014/24067)
rioxxterms.freetoread.startdate2015-12-12


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