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Low Sodium Levels Common After Total Joint Arthroplasty

Postoperative hyponatremia also tied to worse patient outcomes

By Lori Solomon HealthDay Reporter

WEDNESDAY, April 26, 2023 (HealthDay News) — Postoperative hyponatremia is a relatively common occurrence in patients undergoing total joint arthroplasty (TJA), according to a study published online March 31 in the Journal of Bone & Joint Surgery.

Colin M. Baker, D.O., from Thomas Jefferson University in Philadelphia, and colleagues examined the rate of hyponatremia following TJA, as well as the impact of hyponatremia on the perioperative course of TJA patients. The analysis included data for 3,071 primary and revision TJAs performed between 2015 and 2017.

The researchers found that 84.6 percent of patients were normonatremic-normonatremic, 9.4 percent were normonatremic-hyponatremic, 2.1 percent were hyponatremic-normonatremic, and 3.8 percent were hyponatremic-hyponatremic. Risk factors for postoperative hyponatremia included: older age; hip arthroplasty; general anesthesia; higher Charlson Comorbidity Index; congestive heart failure; revision surgery; and history of stroke, liver disease, and chronic kidney disease. Worse outcomes were seen for patients with postoperative hyponatremia, including greater likelihoods of having a 90-day complication, nonhome discharge, and greater length of stay.

“Surgeons should identify patients at risk for developing sodium abnormalities in order to optimize these patients and avoid increased resource utilization,” the authors write.

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