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Prevalence and clinical demographics of cerebral salt wasting in patients with aneurysmal subarachnoid hemorrhage
Pituitary, 06/01/09

Kao L et al. – Cerebral salt wasting syndrome (CSW) is reported in ~23% of pts with a history of aneurysmal subarachnoid hemorrhage (SAH); CSW is not clearly associated with enhanced morbidity and mortality vs pts with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Further studies are critical for pathogenesis, management, and medical consequences of CSW.

Methods

Study of clinical demographics and sequelae of hyponatremia due to CSW in subjects with aneurysmal SAH
Retrospective chart review of pts >18 yrs with aneurysmal SAH admitted between January 2004-July 2007
Subjects with moderate to severe hyponatremia classified into groups consistent with CSW and SIADH based on urine output, fluid balance, natriuresis, and response to saline infusion
Comparison of clinical demographics

Results

Of 316 subjects, hyponatremia in 187 subjects (59.2%) and moderate to severe hyponatremia in 48 (15.2%)
Of latter group, 35.4% categorized with SIADH and 22.9% with CSW
Compared with eunatremic subjects, hyponatremia associated with significantly longer hospital stay
Similar mortality and hospital stay duration for pts with CSW vs SIADH

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