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Association Between Hypernatremia and Delirium After Cardiac Surgery: A Nested Case-Control Study.
Liang Hong1, Xiao Shen1, Qiankun Shi1
1Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Frontiers in Cardiovascular Medicine
|March 31, 2022
Summary
Hypernatremia, or high sodium levels, significantly increases the risk of delirium after cardiac surgery. Early detection and management of hypernatremia are crucial for patient outcomes.
Area of Science:
- Cardiology
- Neurology
- Intensive Care Medicine
Background:
- The link between hypernatremia and delirium post-cardiac surgery is understudied.
- Hypernatremia is defined as serum sodium > 145 mmol/L.
Purpose of the Study:
- To investigate if hypernatremia elevates the risk of delirium following cardiac surgery.
- To quantify the association between hypernatremia and postoperative delirium (POD).
Main Methods:
- A nested case-control study included 7,277 patients undergoing cardiac surgery.
- Hypernatremia exposure was assessed within 7 days pre-operatively.
- Generalized estimation equations were used to analyze the risk of POD associated with hypernatremia.
Main Results:
- 9.2% of patients developed postoperative delirium (669 cases).
- Hypernatremia was present in 66.5% of delirium cases versus 36.3% of controls.
- Hypernatremia significantly correlated with increased POD risk (adjusted OR, 1.73; 95% CI, 1.41–2.12).
Conclusions:
- Hypernatremia is a significant risk factor for delirium after cardiac surgery.
- Findings support improved risk stratification and management strategies for POD.
- The study highlights the importance of monitoring sodium levels in cardiac surgery patients.
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