ArticleWorld journal of gastrointestinal surgery2020
Hyponatremia is associated with more severe biliary disease.
Article in World journal of gastrointestinal surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- Diagnostic Value of Serum Sodium Level and Neutrophil-to-Lymphocyte Ratio in Predicting Severity of Acute Appendicitis: A Retrospective Cross-Sectional Two-Center Study.Medicina (Kaunas, Lithuania) · 2024Article
- Epidemiology and outcomes of hyponatremia in patients with COVID-19-A territory-wide study in Hong Kong.Frontiers in medicine · 2022Article
- Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy.Journal of veterinary internal medicineArticle
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSodium level is an important clinical predictor of complex biliary disease. Hyponatremia has been observed in conjunction with biliary disease, however the nature of this association remains unclear.
aimTo investigate the association between serum sodium and severe biliary disease.
methodsOf 920 patients with gallstone disease treated at the SFVA Hospital from 1989-2019 were studied. We conducted multivariate analyses of correlation between sodium level and biliary disease severity, the presence/location of biliary bacteria, and other factors. Minimum sodium level pre-intervention was collected. Gallstones, bile, and blood (as relevant) were cultured. Illness severity was characterized: (1) None (no infectious manifestations); (2) Systemic inflammatory response syndrome; (3) Severe illness (gangrenous cholecystitis, cholangitis, necrotizing pancreatitis); and (4) Multiple organ dysfunction syndrome (bacteremia, hypotension, organ failure). Comorbidity was defined using the Charlson Comorbidity Index (CCI).
resultsDecreased sodium level significantly correlated with worsening illness severity, ascending bacterial infection, gangrenous changes, elevated CCI score, increasing age, male sex, and glucose. On multivariate analysis, all factors, except age, gender and glucose, independently correlated with sodium level and factors were additive.
conclusionThis unique study is the first to explore, with such granularity, the relationship between biliary disease and sodium. No prior studies have examined specific culture and clinical data. It illustrates an inverse, independent correlation between illness severity and sodium. Culture data demonstrate that sodium decreases as infection ascends from gallstone colonization to bactibilia to bacteremia. Patient comorbidity and gangrenous changes also independently correlate with sodium on multivariate analysis. Sodium level is an important clinical indicator of disease severity for patients with biliary disease.
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