{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:23:09Z","timestamp":1794324189241,"version":"4.9.0"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2014,3]]},"abstract":"\n Object<\/jats:title>\n Intracranial tumors are common pediatric neoplasms and account for substantial morbidity among children with cancer. Hyponatremia is a known complication of neurosurgical procedures and is associated with higher morbidity among neurosurgical patients. The authors aimed to estimate the incidence of hyponatremia, identify clinical characteristics associated with hyponatremia, and assess the association between hyponatremia and patient outcome among children undergoing surgery for intracranial tumors.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This is a retrospective cohort study of children ranging in age from 0 to 19 years who underwent an initial neurosurgical procedure for an intracranial tumor between January 2001 and February 2012. Hyponatremia was defined as serum sodium \u2264 130 mEq\/L during admission.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Hyponatremia during admission occurred in 39 (12%) of 319 patients and was associated with young age and obstructive hydrocephalus (relative risk [RR] 2.9 [95% CI 1.3\u20136.3]). Hyponatremic patients were frequently symptomatic; 21% had seizures and 41% had altered mental status. Hyponatremia was associated with complicated care including mechanical ventilation (RR 4.4 [95% CI 2.5\u20137.9]), physical therapy (RR 4 [95% CI 1.8\u20138.8]), supplemental nutrition (RR 5.7 [95% CI 3.3\u20139.8]), and infection (RR 5.7 [95% CI 3.3\u20139.5]). Hyponatremic patients had a 5-fold increased risk of moderate or severe disability on the basis of their Pediatric Cerebral Performance Category score at discharge (RR 5.3 [95% CI 2.9\u20139.8]). Obstructive hydrocephalus (adjusted odds ratio [aOR] 3.24 [95% CI 1.38\u20138.94]) and young age (aOR 0.92 [95% CI 0.85\u20130.99]) were independently associated with hyponatremia during admission. Hyponatremia was independently associated with moderate or worse disability by Pediatric Cerebral Performance Category score at discharge (aOR 6.2 [95% CI 3.0\u201313.03]).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Hyponatremia was common, particularly among younger children and those with hydrocephalus. Hyponatremia was frequently symptomatic and was associated with more complicated hospital courses. Hyponatremia was independently associated with worse neurological outcome when adjusted for age and tumor factors. This study serves as an exploratory analysis identifying important risk factors for hyponatremia and associated sequelae. Further research into the causes of hyponatremia and the association with poor outcome is needed to determine if prevention and treatment of hyponatremia can improve outcomes in these children.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2013.12.peds13364","type":"journal-article","created":{"date-parts":[[2014,1,10]],"date-time":"2014-01-10T12:06:59Z","timestamp":1389355619000},"page":"283-290","source":"Crossref","is-referenced-by-count":28,"title":["The incidence of postoperative hyponatremia and associated neurological sequelae in children with intracranial neoplasms"],"prefix":"10.3171","volume":"13","author":[{"given":"Cydni N.","family":"Williams","sequence":"first","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Belzer","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Riva-Cambrin","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela P.","family":"Presson","sequence":"additional","affiliation":[{"name":"Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Bratton","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds13364","series-title":"J Neurol Sci","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/S0022-510X(97)00133-0","article-title":"Severe hyponatremia as poor prognostic factor in childhood neurologic diseases","volume":"151","author":"Al-Zahraa Omar","year":"1997"},{"key":"b2-peds13364","series-title":"Support Care Cancer","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1007\/s005200050284","article-title":"A prospective study on hyponatraemia in medical cancer patients: epidemiology, aetiology and differential diagnosis","volume":"8","author":"Berghmans","year":"2000"},{"key":"b3-peds13364","series-title":"Childs Nerv Syst","first-page":"58","article-title":"Hyponatraemia in children with acute CNS disease: SIADH or cerebral salt wasting?","volume":"17","author":"Bussmann","year":"2001"},{"key":"b4-peds13364","series-title":"Pediatr Transplant","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1111\/j.1399-3046.2009.01142.x","article-title":"Hyponatremia increases mortality in pediatric patients listed for liver transplantation","volume":"14","author":"Carey","year":"2010"},{"issue":"Suppl 5","key":"b5-peds13364","series-title":"Neuro Oncol","doi-asserted-by":"publisher","first-page":"v1","DOI":"10.1093\/neuonc\/nos218","article-title":"CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005\u20132009","volume":"14","author":"Dolecek","year":"2012"},{"key":"b6-peds13364","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/S0022-3476(05)82544-2","article-title":"Assessing the outcome of pediatric intensive care","volume":"121","author":"Fiser","year":"1992"},{"key":"b7-peds13364","series-title":"Crit Care Med","doi-asserted-by":"publisher","first-page":"2616","DOI":"10.1097\/00003246-200007000-00072","article-title":"Relationship of pediatric overall performance category and pediatric cerebral performance category scores at pediatric intensive care unit discharge with outcome measures collected at hospital discharge and 1- and 6-month follow-up assessments","volume":"28","author":"Fiser","year":"2000"},{"key":"b8-peds13364","series-title":"Neurocrit Care","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1007\/s12028-011-9618-4","article-title":"Cerebral salt wasting syndrome in post-operative pediatric brain tumor patients","volume":"17","author":"Hardesty","year":"2012"},{"key":"b9-peds13364","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"609","DOI":"10.3171\/2011.3.PEDS1120","article-title":"Perioperative seizure incidence and risk factors in 223 pediatric brain tumor patients without prior seizures. 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