In a report published by Baker et al in the Journal of Bone and Joint Surgery, investigators found that patients with hyponatremia after total knee or hip arthroplasty were more likely to have a longer hospital stay, complications following surgery, and to be discharged to a rehab center rather than their homes. Patients with low sodium levels both before and after surgery had an even higher risk of complications—2.6 times higher than patients with normal sodium levels—than patients with hyponatremia only following surgery (2.1 times higher). Patients who had only presurgical hyponatremia that normalized postarthroplasty had similar outcomes to patients with normal sodium levels, but patients with postoperative hyponatremia that was corrected after surgery but before hospital discharge were at risk for adverse outcomes. Factors associated with postoperative low sodium levels in this population included older age; receipt of hip arthroplasty; use of general anesthesia; higher Charlson Comorbidity Index; congestive heart failure; revision surgery; and history of stroke, liver disease, and chronic kidney disease. The study authors concluded, “Surgeons should identify patients at risk for developing sodium abnormalities in order to optimize these patients and avoid increased resource utilization.”
May 25, 2023