Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy
Abstract Background Patients undergoing cholecystectomy have not been reported previously to develop clinically relevant postoperative hypernatremia. Objectives Describe the frequency of postoperative hypernatremia in dogs undergoing cholecystectomy and its clinical relevance (duration of hospitaliz...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16847 |
| _version_ | 1827310940440231936 |
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| author | Lara Brunori Cormac Dolan Neus Elias Santo‐Domingo |
| author_facet | Lara Brunori Cormac Dolan Neus Elias Santo‐Domingo |
| author_sort | Lara Brunori |
| collection | DOAJ |
| description | Abstract Background Patients undergoing cholecystectomy have not been reported previously to develop clinically relevant postoperative hypernatremia. Objectives Describe the frequency of postoperative hypernatremia in dogs undergoing cholecystectomy and its clinical relevance (duration of hospitalization and survival). Animals Thirty‐seven dogs undergoing cholecystectomy at 2 private referral hospitals. Methods Retrospective study of dogs undergoing cholecystectomy with available preoperative and postoperative serum sodium concentrations. Results Postoperative hypernatremia (>150 mEq/L) was common (56%; 95% confidence interval [CI], 40%‐70%) and was associated with significantly higher mortality compared to nonhypernatremic patients (52%; 95% CI, 30%‐70% vs 12.5%; 95% CI, 2%‐40%; P = .02). Nonsurvivors had higher mean postoperative peak serum sodium concentrations (155 mEq/L; range, 146‐172) than survivors (150 mEq/L; range, 142‐156; P = .01). Dogs developing hypernatremia within 6 hours after surgery had 7.7 higher odds of nonsurvival (odds ratio [OR], 7.7; 95% CI, 5.9‐9.4). A delta value (serum sodium concentration on admission [T0] − serum sodium concentration 6 hours postoperatively [T2]) of ≥10 mEq/L carried 3.3 higher odds of mortality (OR, 3.3; 95% CI, 1.6‐5.1). All dogs with a postoperative peak sodium concentration >160 mEq/L did not survive. Admission acute patient physiologic laboratory evaluation fast (APPLEfast) scores were not different between survivors and nonsurvivors or between postoperative hypernatremic and normonatremic patients. Hospitalization time was no different between hypernatremic and normonatremic patients (6 days vs 4.5 days; P = .15). Dogs with gallbladder mucocele were more likely to develop postoperative hypernatremia and have poorer outcomes. Conclusions Hypernatremia was a common and clinically relevant postoperative complication in dogs after cholecystectomy. Detection of hypernatremia within 6 hours after surgery may be associated with poorer outcomes. |
| first_indexed | 2024-03-09T00:19:33Z |
| format | Article |
| id | doaj.art-ae68294f1ea845238b55a9abbd7ee184 |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-24T20:09:06Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-ae68294f1ea845238b55a9abbd7ee1842024-03-23T17:56:17ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762023-11-013762171217710.1111/jvim.16847Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomyLara Brunori0Cormac Dolan1Neus Elias Santo‐Domingo2Emergency & Critical Care Specialist Service VetsNow 24/7 Pet Emergency & Specialty Hospital Glasgow United KingdomEmergency & Critical Care Specialist Service VetsNow 24/7 Pet Emergency & Specialty Hospital Glasgow United KingdomEmergency & Critical Care Specialist Service VetsNow 24/7 Pet Emergency & Specialty Hospital Glasgow United KingdomAbstract Background Patients undergoing cholecystectomy have not been reported previously to develop clinically relevant postoperative hypernatremia. Objectives Describe the frequency of postoperative hypernatremia in dogs undergoing cholecystectomy and its clinical relevance (duration of hospitalization and survival). Animals Thirty‐seven dogs undergoing cholecystectomy at 2 private referral hospitals. Methods Retrospective study of dogs undergoing cholecystectomy with available preoperative and postoperative serum sodium concentrations. Results Postoperative hypernatremia (>150 mEq/L) was common (56%; 95% confidence interval [CI], 40%‐70%) and was associated with significantly higher mortality compared to nonhypernatremic patients (52%; 95% CI, 30%‐70% vs 12.5%; 95% CI, 2%‐40%; P = .02). Nonsurvivors had higher mean postoperative peak serum sodium concentrations (155 mEq/L; range, 146‐172) than survivors (150 mEq/L; range, 142‐156; P = .01). Dogs developing hypernatremia within 6 hours after surgery had 7.7 higher odds of nonsurvival (odds ratio [OR], 7.7; 95% CI, 5.9‐9.4). A delta value (serum sodium concentration on admission [T0] − serum sodium concentration 6 hours postoperatively [T2]) of ≥10 mEq/L carried 3.3 higher odds of mortality (OR, 3.3; 95% CI, 1.6‐5.1). All dogs with a postoperative peak sodium concentration >160 mEq/L did not survive. Admission acute patient physiologic laboratory evaluation fast (APPLEfast) scores were not different between survivors and nonsurvivors or between postoperative hypernatremic and normonatremic patients. Hospitalization time was no different between hypernatremic and normonatremic patients (6 days vs 4.5 days; P = .15). Dogs with gallbladder mucocele were more likely to develop postoperative hypernatremia and have poorer outcomes. Conclusions Hypernatremia was a common and clinically relevant postoperative complication in dogs after cholecystectomy. Detection of hypernatremia within 6 hours after surgery may be associated with poorer outcomes.https://doi.org/10.1111/jvim.16847gallbladdergallbladder diseasegallbladder mucocelepostoperative complicationsodium |
| spellingShingle | Lara Brunori Cormac Dolan Neus Elias Santo‐Domingo Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy Journal of Veterinary Internal Medicine gallbladder gallbladder disease gallbladder mucocele postoperative complication sodium |
| title | Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy |
| title_full | Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy |
| title_fullStr | Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy |
| title_full_unstemmed | Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy |
| title_short | Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy |
| title_sort | occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy |
| topic | gallbladder gallbladder disease gallbladder mucocele postoperative complication sodium |
| url | https://doi.org/10.1111/jvim.16847 |
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