Preoperative hyponatremia in women with ovarian cancer: An additional cause for concern?☆
Section snippets
Background
The optimal therapy for advanced ovarian cancer includes both surgery and chemotherapy [1]. Cytoreductive surgery to a goal of minimal residual disease has been associated with improvements in disease-free and overall survival [2]. Extensive surgical procedures are often required to achieve the goal of complete cytoreduction [3], [4] which can be associated with substantial morbidity as well as mortality [5]. In order to reduce the morbidity of surgery, neoadjuvant chemotherapy (NAC) may be
Data source/study design
ACS NSQIP is a surgical quality improvement program designed to measure and improve surgical outcomes. Currently, 699 hospitals nationwide participate in the ACS NSQIP program. The ACS NSQIP database contains variables on preoperative and intraoperative factors, and postoperative 30-day morbidity and mortality on patients who underwent major outpatient or inpatient surgical procedures. Surgical cases are selected using an 8-day cycle systematic sampling process at each site to minimize selection
Results
Four thousand seven hundred eighty-eight women with ovarian, PPC, and FT cancers were identified in the ACS NSQIP database from 2005 to 2013. Subjects with a missing preoperative serum sodium measurement (n = 354), hypernatremia (n = 350) and those that did not have a cytoreductive procedure (n = 75) were excluded. This left 4009 evaluable women. Women who were excluded for a missing preoperative serum sodium were more likely to be younger and were less likely to have preoperative weight loss,
Discussion
Hyponatremia is the most common electrolyte abnormality among hospitalized patients. We found that women with preoperative hyponatremia undergoing cytoreductive procedures for ovarian, PPC, and FT were more likely to experience 30-day postoperative complications such as prolonged hospital stay and 30-day mortality. Few studies have examined the association between preoperative hyponatremia and perioperative complications. The most notable was a large population-based study that used the NSQIP
Conflict of interest statement
The authors declare that there are no conflicts of interest.
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Cited by (12)
Sodium Abnormalities Are an Independent Predictor of Complications in Total Joint Arthroplasty: A Cautionary Tale!
2021, Journal of ArthroplastyCitation Excerpt :In a retrospective review of 4370 patients undergoing cardiovascular surgery at a single institution, Crestanello et al [17] found that preoperative hyponatremia independently predicted increased LOS (13 vs 8 days), early mortality (9% vs 4%), and late mortality (24% vs 16%). In a respective review of the 4009 patients undergoing gynecologic surgery using the ACS-NSQIP, Martin et al [18] demonstrated higher risk of increased LOS and 30-day mortality with preoperative hyponatremia. In another retrospective review of the ACS-NSQIP, Leung et al [19] found that hypernatremia was associated with higher rates of coronary events, pneumonia, venous thromboembolism, and mortality among patients undergoing major general, vascular, orthopedic, and cardiac surgeries.
Hyponatremia as a Prognostic Factor in Advanced Stage Ovarian Cancer Patients
2023, Chirurgia (Romania)The Role of Hyponatraemia Before Surgery in Patients With Radical Resected Pancreatic Cancer
2020, Clinical Medicine Insights: Oncology
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Accepted as a poster presentation at the Annual Meeting of the Society for Gynecologic Oncology, San Diego, CA, March 2016.