Hyponatremia as a Predictor of Complicated Appendicitis

Area of Science:

• Medical research
• Surgical emergencies
• Clinical diagnostics

Background:

• Acute appendicitis is a common surgical emergency with uncomplicated and complicated forms.
• Complicated appendicitis (perforation, abscess, inflammatory mass) has poorer outcomes.
• Previous studies suggested hyponatremia predicts complicated appendicitis, but Middle Eastern data were limited.

Purpose of the Study:

• To investigate hyponatremia as a predictor of complicated acute appendicitis.
• To evaluate the association between serum sodium levels and appendicitis severity in a Saudi Arabian cohort.

Main Methods:

• Quantitative, retrospective cohort study of 965 patients at Buraidah Central Hospital, Saudi Arabia (Jan 2020-Dec 2023).
• Included patients aged 14+ with complete records; excluded those with uncomplicated appendicitis or comorbidities affecting sodium.
• Analyzed demographic, laboratory, and clinical data using Python, applying inverse probability of treatment weighting; p < 0.05.

Main Results:

• Overall hyponatremia prevalence was 11.3%; 4% in complicated appendicitis.
• Contrary to hypothesis, higher serum sodium levels (AdjOR = 1.207) and age (AdjOR = 1.027) were significantly associated with complicated appendicitis.
• These associations remained significant across gender and surgical procedure stratifications.

Conclusions:

• A paradoxical positive association exists between serum sodium levels and complicated appendicitis, differing from prior hyponatremia-based evidence.
• Serum sodium alone is not a reliable predictor but enhances diagnostic value with other parameters.
• Combined assessment of serum sodium and patient age may improve early risk stratification for appendicitis.