To evaluate the outcomes of patients with mild postoperative hyponatremia following total joint arthroplasty (TJA) compared to those who remained normonatremic postoperatively.
Key Findings:
Postoperative hyponatremia occurred in 21% of patients, with AKI being a significant factor in complications.
Patients with postoperative hyponatremia had 1.75 times the odds of medical complications and 1.63 times the odds of overall complications compared to normonatremic patients, largely driven by AKI.
No significant differences in surgical outcomes or readmission rates were found between hyponatremic and normonatremic patients.
Sodium levels of 132 and 133 mEq/L were associated with higher odds of complications, but these associations disappeared when AKI was excluded.
Interpretation:
The study suggests that mild postoperative hyponatremia may not significantly impact 90-day outcomes in TJA patients, particularly when AKI is excluded from the analysis.
Limitations:
Retrospective design and single-institution study limit generalizability.
Excluded same-day discharge procedures and patients with hypernatremia, which may affect the findings.
Could not assess medication use, hydration protocols, or underlying causes of hyponatremia.
Sodium measurements were limited to postoperative day 1.
Conclusion:
Asymptomatic mildly hyponatremic patients may be safely discharged without incurring additional management costs, although further research is needed to clarify the impact of sodium normalization before discharge.
These 10 states make it more practical for physicians to participate in hospital ownership by aligning statutory structure, corporate practice of medicine rules, and population trends.
