ISSN : 2146-3123
E-ISSN : 2146-3131

Clinical and Predictive Significance of Hyponatremia after Aneurysmal Subarachnoid Hemorrhage
Snežana Stanisavljevic 1, Gordana Javanovic 1, Snežana Stanisavljevic 1, Arsen Uvelin 2, Jelena Panti Vrsajkov 3
1Department of Anesthesia and Intensive Care, Clinical Centre of Vojvodina, Novi Sad, Serbia
2Clinical Centre of Vojvodina, Emergency Centre, Novi Sad, Serbia
3Health Care Centre “Novi Sad, Novi Sad, Serbia
DOI : 10.5152/balkanmedj.2012.037
Pages : 243-246


Objective: Hyponatremia after SAH was the object of several studies with conflicting results. The aim of this study was to determine  a predictive correlation of hyponatremia with delayed cerebral ischemia (DCI) and poor clinical outcome.

Material and Methods: We have used a retrospective hospital chart review of 82 patients with SAH treated from August 2008 to August 2010. Patients were divided into hyponatremia and normonatremia groups. Hyponatremia was defined as serum sodium level <135 mmol/l. Information compared and analyzed included demographics, preoperative neurological status, aneurysm characteristics, postoperative intensive care, duration of stay, DCI and clinical outcome at hospital discharge. P<0.05 was considered significant.

Results: Thirty-two patients with SAH (39%) developed hyponatremia. In that group we had a significantly higher WFNS score at admission (p=0.03) and longer duration of stay in intensive care (p=0.001). DCI with transit or definitive deficit included  20 patients (62%) in  the hyponatremia group, and 19 patients (38%) in the  normonatremia group (p=0.03). Binary enter logistic regression revealed  a significant correlation of hyponatremia with DCI (p=0.03) and poor clinical outcome (p=0.001).

Conclusion: This result  revealed  a possible use of hyponatremia as an additional predictor of developing DCI and poor clinical outcome.

Keywords : Hyponatremia, cerebral ischemia, subarachnoid hemorrhage, Glasgow outcome scale
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