he incidence of delayed hyponatremia is 16-28% and usually accounts for unplanned readmission of the patient within 30 days after transsphenoidal surgery. One of the surrogate measures of quality of care adopted by the government and regulatory agencies is 30-day unplanned readmission. Hence the authors tried to determine the impact of a delayed hyponatremia (DH) care pathway on the 30-day readmission after transsphenoidal surgery. The study found that although the pathway helped to identify more patients with DH, it did not reduce readmission rates and did not help change clinical outcomes. As patients can present either with acute DH or can be symptomatic even before reaching low sodium levels, the authors suggest that close monitoring of the patients may be an alternative to routine screening. 

Implementation of a postoperative outpatient care pathway for delayed hyponatremia following transsphenoidal surgery.
Bohl MA, Ahmad S, White WL, Little AS.
NEUROSURGERY
2018;82:110-17.
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CONTRIBUTOR
Gauri Mankekar

Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.

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