Observational studyActa neurochirurgica2022
The management and outcome of hyponatraemia following transsphenoidal surgery: a retrospective observational study.
Observational study in Acta neurochirurgica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Incidence and risk factors of hyponatremia after transsphenoidal surgery: a systematic meta-analysis.Neurosurgical review · 2025Pooled it
- Postoperative fluid restriction to prevent delayed hyponatremia after endoscopic transsphenoidal surgery.Neuro-oncology · 2025Trial
- First-in-human evaluation of real-time pixel-level AI-assisted anatomical segmentation in neurosurgery: pituitary surgery as an exemplar.Pituitary · 2026Article
- Article
- Fluid-therapy for Brain Surgery: A Narrative Review.Turkish journal of anaesthesiology and reanimation · 2026Article
- Surveillance intensity influences the observed incidence of delayed hyponatremia after microscopic transsphenoidal pituitary surgery: early sodium and sex as risk stratifiers.Frontiers in endocrinology · 2026Article
- Article
- Glucocorticoids and Water Balance: Implications for Hyponatremia Management and Pituitary Surgery.Neuroendocrinology · 2023Review
- Disorders of Salt and Water Balance After Pituitary Surgery.The Journal of clinical endocrinology and metabolism · 2022Article
- Sodium disorders in neuroanaesthesia and neurocritical care.BJA education · 2022Review
- Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHyponatraemia is a common complication following transsphenoidal surgery. However, there is sparse data on its optimal management and impact on clinical outcomes. The aim of this study was to evaluate the management and outcome of hyponatraemia following transsphenoidal surgery.
methodsA prospectively maintained database was searched over a 4-year period between January 2016 and December 2019, to identify all patients undergoing transsphenoidal surgery. A retrospective case-note review was performed to extract data on hyponatraemia management and outcome.
resultsHyponatraemia occurred in 162 patients (162/670; 24.2%) with a median age of 56 years. Female gender and younger age were associated with hyponatraemia, with mean nadir sodium being 128.6 mmol/L on postoperative day 7. Hyponatraemic patients had longer hospital stay than normonatraemic group with nadir sodium being inversely associated with length of stay (p < 0.001). In patients with serum sodium ≤ 132 mmol/L, syndrome of inappropriate antidiuretic hormone secretion (SIADH) was the commonest cause (80/111; 72%). Among 76 patients treated with fluid restriction as a monotherapy, 25 patients (25/76; 32.9%) did not achieve a rise in sodium after 3 days of treatment. Readmission with hyponatraemia occurred in 11 cases (11/162; 6.8%) at a median interval of 9 days after operation.
conclusionHyponatraemia is a relatively common occurrence following transsphenoidal surgery, is associated with longer hospital stay and risk of readmission and the effectiveness of fluid restriction is limited. These findings highlight the need for further studies to better identify and treat high-risk patients, including the use of arginine vasopressin receptor antagonists.
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