• Changhong Mo, Maoxiang Li, Yangyang Li, Yi Liu, Ruijing Zhao, Hao Wang, Jiliang Hu, and Wei Guo.
• The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China.
• World Neurosurg. 2024 Jul 1; 187: e35e41e35-e41.

BackgroundTo identify high-risk patients for delayed postoperative hyponatremia (DPH) early, we constructed a simple and effective scoring system.MethodsWe retrospectively analyzed 141 consecutive patients who underwent endoscopic transsphenoidal surgery from January 2019 to December 2022. Patients were divided into DPH group and nondelayed postoperative hyponatremia group based on whether hyponatremia occurred after the third postoperative day. Multivariable logistic regression analysis was conducted to determine the predictive factors of DPH, and a simple scoring system was constructed based on these predictors.ResultsAmong 141 patients, 36 (25.5%) developed DPH. Multivariable logistic regression analysis showed that age ≥48 years (odds ratio [OR], 3.74; 95% confidence interval [CI], 1.14-12.21; P = 0.029), Knosp grade ≥3 (OR, 5.17; 95% CI, 1.20-22.27; P = 0.027), postoperative hypokalemia within three days (OR, 3.13; 95% CI, 1.05-9.33; P = 0.040), a difference in blood sodium levels between the first and second day after surgery ≥1 mEq/L (OR, 3.65; 95% CI, 1.05-12.77; P = 0.043), and postoperative diabetes insipidus (OR, 3.57; 95% CI, 1.16-10.96; P = 0.026) were independent predictors of DPH.ConclusionsThis scoring system for predicting DPH has an area under the receiver operating characteristic curve of 0.856 (95% CI, 0.787-0.925), indicating moderate to good predictive value for DPH in our cohort, but further prospective external validation is needed.Copyright © 2024 Elsevier Inc. All rights reserved.

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