Table 1.
a. Patient demographics and interventions received by hyponatremia subgroups classified by patient’s lowest sodium during the first 14 days managed with an externalized ventricular drain (EVD).
| Moderate and Severe Hyponatremia | Mild Hyponatremia | No Hyponatremia | |||
|---|---|---|---|---|---|
| Total | Na <130 meq/L | Na 131-134 meq/L | Na >=135meq/L | p-value | |
| n =380 | n =30 (8) | n =109 (29) | n =241 (63) | ||
| Demographics | |||||
| Age (years) | 6.5 [2.1, 13.9] | 3.5 [1.3, 8.7] | 5 [ 1.9, 11.9] | 7.8 [2.3, 14.3] | 0.015 |
| Sex | 0.49 | ||||
| Male | 169 (44) | 16 (53) | 45 (41) | 108 (45) | |
| Female | 211 (56) | 14 (47) | 64 (59) | 133 (55) | |
| PRISM score at 24 hours | 319 | 4 [0,9] | 3 [0,5] | 0 [0,5] | 0.01 |
| Ventriculostomy Indication | 0.038 | ||||
| Tumor | 122 (32) | 7 (23) | 39 (36) | 76 (32) | |
| TBI | 17 (5) | 3 (18) | 1 (1) | 13 (5) | |
| Spontaneous ICH | 23 (6) | 1 (4) | 9 (8) | 13 (5) | |
| Ventricular shunt Externalization/other | 209 (54) | 16 (53) | 58 (53) | 135 (56) | |
| Meningitis | 9 (2) | 3 (10) | 2 (2) | 4 (2) | |
| Preexisting Epilepsy | 73 (19) | 6 (20) | 21 (19) | 46 (19) | 0.99 |
| Admission Sodium | 138 [137, 141] | 136.5 [132,139] | 138 [136,140] | 139 [138, 141] | <0.001 |
| Maximum Daily CSF Output (ml) | 279 [168, 374] | 314 [215, 406] | 256 [177, 368] | 282 [142, 346] | 0.38 |
| Maximum Sodium Level | 141 [139, 144] | 142 [138, 150] | 140 [138, 143] | 141 [139, 144] | 0.03 |
| Magnitude of Maximum Daily Sodium Fluctuation (meq/L) | 2 [0,6] | 8[5, 11] | 4 [0,8] | 0 [0,4] | <0.001 |
| Magnitude Sodium Fluctuation | 5 [2.5, 9] | 16 [11, 24] | 7 [4,11] | 3 [1,6] | <0.001 |
| Hospital day of lowest Na | 2 [1, 4.5] | 3 [2, 7] | 2 [1,5] | 2 [1,4] | 0.027 |
| Interventions | |||||
| Normal Saline | 377 (99) | 30 (8) | 109 (29) | 238 (63) | 0.65 |
| Three percent Saline | 56 (15) | 11 (37) | 21(19) | 24 (10) | <0.001 |
| Quarter NormalSaline | 4 (1) | 1 (3) | 1 (1) | 2 (1) | 0.35 |
| Half NormalSaline | 18 (5) | 4 (13) | 3 (3) | 11 (5) | 0.069 |
| Total Parenteral Nutrition | 33 (9) | 12 (40) | 9 (8) | 12 (5) | <0.001 |
| Oral Sodium Supplementation | 27 (7) | 13 (43) | 12 (11) | 2 (1) | <0.001 |
| Days with ventriculostomy | 6 [4,9] | 11 [6, 14] | 7 [4, 11] | 6 [3,8] | <0.001 |
| b. The magnitude of patients’ maximum daily sodium fluctuation (difference between highest and lowest sodium each day) and the magnitude of patients’ sodium fluctuation (difference between highest and lowest sodium) during the first 14 days managed with an externalized ventricular drain (EVD). | ||||
| N =380 | Magnitude of Maximum Daily Sodium Fluctuation (meq/L) Median [IQR] | Magnitude of sodium fluctuation (meq/L) Median [IQR] | ||
| p-value | p-value | |||
| Sex | 0.49 | 0.17 | ||
| Male | 0 [2,6] | 6 [3,10] | ||
| Female | 0 [2,6] | 5 [2,9] | ||
| Ventriculostomy Indication | <0.001 | <0.001 | ||
| Tumor | 3 [1,7] | |||
| TBI | 10 [8,11] | 19 [10, 26] | ||
| Spontaneous ICH | 7 [4,8] | 9 [7, 19] | ||
| Ventricular Shunt Externalization /other | 0 [0,2] | 4 [2,7] | ||
| Meningitis | 4 [0,7] | 9 [6,11] | ||
| Preexisting Epilepsy | 0.03 | 0.65 | ||
| Yes | 0 [0, 5] | 5 [2,11] | ||
| No | 2 [0, 6] | 5 [3,9] | ||
| ICP>20 (n=154) | 0.002 | <0.001 | ||
| Yes | 4 [0,8] | 10 [6, 19] | ||
| No | 3 [0,7] | 6[3,11] | ||
| Interventions | ||||
| Normal Saline | 0.74 | 0.42 | ||
| Yes | 2 [0,6] | 5 [3, 9] | ||
| No | 0 [0, 11] | 0 [0, 29] | ||
| Three Percent Saline | <0.001 | <0.001 | ||
| Yes | 8 [6, 11] | 17 [9.5, 24] | ||
| No | 1 [0,4] | 5 [2,7] | ||
| Quarter Normal Saline | 0.012 | 0.007 | ||
| Yes | 8 [6.5, 11.5] | 15.5 [14. 20.5] | ||
| No | 2 [0,6] | 5 [2, 9] | ||
| Half Normal Saline | 0.11 | 0.018 | ||
| Yes | 6.5 [0,14] | 12.5 [3, 24] | ||
| No | 2 [0,6] | 5 [2, 9] | ||
| Total Parenteral Nutrition | <0.001 | <0.001 | ||
| Yes | 7 [5,9] | 15 [9, 23] | ||
| No | 1 [0,5] | 5 [2, 8] | ||
| Oral sodium supplementation | <0.001 | <0.001 | ||
| Yes | 5 [2,9] | 12 [7, 15] | ||
| No | 1 [0,5] | 5 [2, 8] | ||
| ICP > 20 (n=164) | <0.001 | <0.001 | ||
| Yes | 7 [3,10] | 10 [6, 19] | ||
| No | 4 [0,8] | 6 [3, 11] | ||
CSF: cerebral spinal fluid, ICH: Intracranial hemorrhage, ICP: Intracranial pressure, IQR: interquartile range, ml: milliters, Na: sodium, meq/L: milliequivalents per Liter, TBI: traumatic brain injury, median [IQR]; n(%)