Delayed Symptomatic Hyponatremia Epidemiology [Neurosurgery Wiki]

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====== Delayed Symptomatic Hyponatremia Epidemiology ======

Delayed [[hyponatremia]] following [[transsphenoidal surgery]] is a known [[complication]], with a peak incidence of 4-7 days post-operatively
((Zada G, Liu CY, Fishback D, Singer PA, Weiss MH. Recognition and management of
delayed hyponatremia following transsphenoidal pituitary surgery. J Neurosurg.
2007 Jan;106(1):66-71. PubMed PMID: 17236489.
))
((Hensen J, Henig A, Fahlbusch R, Meyer M, Boehnert M, Buchfelder M. Prevalence,
predictors and patterns of postoperative polyuria and hyponatraemia in the
immediate course after transsphenoidal surgery for pituitary neuroendocrine tumors. Clin
Endocrinol (Oxf). 1999 Apr;50(4):431-9. PubMed PMID: 10468901.
))
((Kelly DF, Laws ER, Jr., Fossett D. Delayed hyponatremia after transsphenoidal surgery
for pituitary neuroendocrine tumor. Report of nine cases. J Neurosurg. 1995;83(2):363-367.)).

It is a common cause of [[hospital readmission]], due to fluid retention resulting in reduction of
plasma [[sodium]] concentration below physiologic levels
((Bohl MA, Ahmad S, Jahnke H, et al. Delayed Hyponatremia Is the Most Common Cause
of 30-Day Unplanned Readmission After Transsphenoidal Surgery for Pituitary Tumors.
Neurosurgery. 2015.)).
----
In a database of 466 consecutive patients who underwent endoscopic transsphenoidal surgery at a tertiary care center between April 2006 and July 2014 was reviewed for 30-day causes for readmission, length of stay, level of care required, and average cost.

Twenty-nine readmissions were identified within the study period, indicating a 30-day readmission rate of 6.2%. Among all patients, rates of 30-day readmission were 2.1% for epistaxis, 1.5% for hyponatremia, 0.9% for cerebrospinal fluid leak, and 1.7% for other medical conditions. Average cost per readmission ranged from $6011 for hyponatremia to $24,613 for cerebrospinal fluid leak
((Hendricks BL, Shikary TA, Zimmer LA. Causes for 30-Day Readmission following
Transsphenoidal Surgery. Otolaryngol Head Neck Surg. 2016 Feb;154(2):359-65. doi:
10.1177/0194599815617130. Epub 2015 Nov 17. PubMed PMID: 26577772.
)).