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dc.contributor.authorKlinck, J
dc.contributor.authorMcNeill, L
dc.contributor.authorDi Angelantonio, E
dc.contributor.authorMenon, DK
dc.date.accessioned2014-09-30T14:17:49Z
dc.date.available2014-09-30T14:17:49Z
dc.date.issued2015-04
dc.identifier.citationKlink et al. The British Journal of Anaesthesia (2014) Vol. 114, Issue 4, pp. 615-622. DOI: 10.1093/bja/aeu409
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 7 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 >5 mmol litre(-1). RESULTS: Changes in sodium concentration >5 mmol litre(-1) were associated with increased mortality risk (adjusted odds ratio 1.49 for a decrease, 3.02 for an increase). Factors independently associated with a perioperative decrease in serum sodium concentration >5 mmol litre(-1) included age >60, diabetes mellitus, and the 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 haemorrhage. 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.languageEnglish
dc.language.isoen
dc.publisherElsevier BV
dc.subjectHospital Mortality
dc.subjectPerioperative Period
dc.subjectSodium
dc.titlePredictors and outcome impact of perioperative serum sodium changes in a high-risk population.
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/aeu409
prism.endingPage622
prism.publicationDate2014
prism.publicationNameBr J Anaesth
prism.startingPage615
prism.volume114
rioxxterms.versionofrecord10.1093/bja/aeu409
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2014
dc.contributor.orcidDi Angelantonio, Emanuele [0000-0001-8776-6719]
dc.contributor.orcidMenon, David [0000-0002-3228-9692]
dc.identifier.eissn1471-6771
rioxxterms.typeJournal Article/Review
pubs.funder-project-idMedical Research Council (G0001354)
pubs.funder-project-idMedical Research Council (MR/L003120/1)
pubs.funder-project-idBritish Heart Foundation (None)
cam.issuedOnline2014-12-12
rioxxterms.freetoread.startdate2015-12-12


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