Fluid Restriction Reduces Delayed Hyponatremia and Hospital Readmissions After Transsphenoidal Surgery
Main finding · Delayed hyponatremiaResult — go to the resultRelative risk 0.52Authors' conclusion
Restricting fluid to 1 L/day on discharge decreases rates of delayed hyponatremia and readmissions by 50%. Standardized patient education and POD 7 sodium testing decreases severity of hyponatremia but does not impact readmission rates. These protocols should be considered standard practice for patients undergoing transsphenoidal surgery.
Study context
- Population
- Patients undergoing transsphenoidal surgery for pituitary adenomas and other sellar and parasellar pathologies, tertiary referral hospital
- Participants
- 296 / 316 / 110
- Exposure
- Phase 1 vs phase 2 vs phase 3
- Phase 1n = 296reference
- Phase 2n = 316
- Phase 3n = 110
- Outcome
- Rates of early and delayed hyponatremia and readmissions
Methodological detailstwo retrospective analyses and 1 prospective study, single-centre
- Two retrospective analyses and 1 prospective study
- Single-centre
Main finding
Delayed hyponatremia
Relative risk
0.52
By group
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Phase 2 | Phase 3 | RR (CI) | |
|---|---|---|---|---|
| ReadmissionsPhase 3vs Phase 1Readmissions reduced 3-fold | — not stated in the abstract | 4.6% | 0.30 (0.12–0.73) | |
| 0.10.31310Relative risk (log scale) |
— not stated in the abstract
| Outcome | Phase 2 | Phase 3 |
|---|---|---|
| Early hyponatremia | 22% | — not stated in the abstract |
| Compliance with POD 7 sodium testing | 89% | — not stated in the abstract |
— not stated in the abstract
Readmissions
- Phase 3: readmissions for hyponatremia markedly reduced
- Phase 2: readmissions unchanged
Severity of hyponatremia
- Phase 2: severity of hyponatremia reduced
- 60%
Readmission costs
- Hyponatremia readmission increased costs
- 30%
Original publication
Fluid Restriction Reduces Delayed Hyponatremia and Hospital Readmissions After Transsphenoidal Surgery. J Clin Endocrinol Metab. Published 1 February 2023. doi:10.
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