Characteristics and outcome of acute medical admissions with hyponatremia: even mild hyponatremia is associated with higher mortality

Characteristics and outcome of acute medical admissions with hyponatremia: even mild hyponatremia is associated with higher mortality

Abstract

Hyponatremia is a common finding in hospitalized patients. In this retrospective cohort study we assessed the characteristics and outcome of acute medical admissions with hyponatremia. Compared to the normal sodium group, those with hyponatremia were significantly older and the Charlson Comorbidity Index (CCI) was higher. The number of admissions to MCU/ICU between both groups was similar, but hyponatremic patients had a longer length of stay and both 28-day and one-year mortality were higher, even in patients with mild hyponatremia. Hyponatremia was independently associated with mortality after adjustment for age, CCI and polypharmacy, as was found in the subgroup with mild hyponatremia.

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References

  1. Reddy P, Mooradian AD; Diagnosis and management of hyponatraemia in hospitalised patients. Int J Clin Pract 2009; 63(10): 1494–508. doi: 10.1111/j.1742–1241.2009.02103.x.
  2. Hoorn EJ, Lindemans J, Zietse R; Development of severe hyponatraemia in hospitalized patients: treatment-related risk factors and inadequate management. Nephrol Dial Transplant 2006; 21(1): 70–6. Epub 2005 Sep 2.
  3. Arampatzis S, Frauchiger B, Fiedler GM, et al; Characteristics, symptoms, and outcome of severe dysnatremias present on hospital admission. Am J Med 2012; 125(11): 1125.e1-1125.e7.doi: 10.1016/j.amjmed.2012.04.041. Epub 2012 Aug 28.
  4. Olsson K, Öhlin B, Melander O; Epidemiology and characteristics of hyponatremia in the emergency department. Eur J Intern Med 2013; 24(2): 110–6.
  5. Nzerue CM, Baffoe-Bonnie H, You W, et al; Predictors of outcome in hospitalized patients with severe hyponatremia. J Natl Med Assoc 2003; 95(5): 335–43.
  6. Wald R, Jaber BL, Price LL, et al; Impact of hospital-associated hyponatremia on selected outcomes. Arch Intern Med 2010; 170(3): 294–302.
  7. Conway R, Byrne D, O’Riordan D, et al; Hyponatraemia in Emergency Medical Admissions - Outcomes and Costs. J Clin Med 2014; 3(4): 1220–1233.
  8. Holland-Bill L, Christiansen CF, Heide-Jørgensen U, et al; Hyponatremia and mortality risk: a Danish cohort study of 279508 acutely hospitalized patients. Eur J Endocrinol 2015; 173(1): 71–81. doi: 10.1530/EJE-15-0111.
  9. Kang SH, Kim HW, Lee SY, et al. Is the sodium level per se related to mortality in hospitalized patients with severe hyponatremia? Clin Nephrol 2012; 77(3): 182–7.
  10. Chawla A, Sterns RH, Nigwekar SU, et al; Mortality and serum sodium: do patients die from or with hyponatremia? Clin J Am Soc Nephrol 2011; 6(5): 960–5. doi: 10.2215/CJN.10101110. Epub 2011 Mar 24.
  11. Whelan B, Bennett K, O’Riordan D, et al; Serum sodium as a risk factor for in-hospital mortality in acute unselected general medical patients. QJM 2009; 102(3): 175–82. doi: 10.1093/qjmed/hcn165. Epub 2008 Dec 23.
  12. Tzoulis P, Bagkeris E, Bouloux PM; A case-control study of hyponatraemia as an independent risk factor for inpatient mortality. Clin Endocrinol 2014; 81: 401–407.
  13. Corona G, Giuliani C, Parenti G, et al; Moderate Hyponatremia Is Associated with Increased Risk of Mortality: Evidence from a Meta-Analysis. PLoS One 2013; 8(12): e80451.
  14. Brouns SHA, Dortmans MKJ, Jonkers FS, et al; Hyponatraemia in elderly emergency department patients: A marker of frailty. Neth J Med 2014; 72(6): 311–7.
  15. Lee CT, Guo HR, Chen JB; Hyponatremia in the emergency department. Am J Emerg Med 2000; 18(3): 264–8.
  16. Lindner G, Pfortmüller CA, Leichtle AB, et al; Age-related variety in electrolyte levels and prevalence of dysnatremias and dyskalemias in patients presenting to the emergency department. Gerontology 2014; 60(5): 420–3. doi: 10.1159/000360134. Epub 2014 May 20.
  17. Basile-Filho A, Menegueti MG, Nicolini EA, et al; Are the Dysnatremias a Permanent Threat to the Critically Ill Patients? J Clin Med Res 2016; 8(2): 141–6. doi: 10.14740/jocmr2425w.Epub 2015 Dec 28.
  18. Arampatzis S, Exadaktylos A, Buhl D, et al; Dysnatraemias in the emergency room: Undetected, untreated, unknown? Wien Klin Wochenschr 2012 Mar; 124(5–6): 181–3. doi: 10.1007/s00508-011- 0108–7. Epub 2011 Dec 21.
  19. Thijssen WA, Giesen PH, Wensing M; Emergency departments in The Netherlands. Emerg Med J 2012; 29(1): 6–9. doi: 10.1136/emermed-2011-200090. Epub 2011 Oct 28.
  20. ICD-10. http://class.who-fic.nl/browser.aspx?scheme=ICD10-nl.cla. Accessed on January, 10th, 2014.
  21. Ramiarina RA, Ramiarina BL, Almeida RM, et al; Comorbidity adjustment index for the international classification of diseases, 10th revision. Rev Saude Publica 2008; 42(4): 590–7.
  22. Mackway-Jones K; Manchester Triage Group. Emergency Triage. 2nd ed.: Bmj Publishing Group; 2005.
  23. Hillier TA, Abbott RD, Barrett EJ; Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med 1999; 106(4): 399–403.
  24. Assen A Abouem D, Vandergheynst F, Nguyen T, et al; Hyponatremia at the Emergency Department: A case-control study. Minerva Anestesiol 2014; 80: 419–428.
  25. Waikar SS, Mount DB, Curhan GC; Mortality after Hospitalization with Mild, Moderate, and Severe Hyponatremia. Am J Med 2009; 122(9): 857–865. doi:10.1016/j.amjmed.2009.01.027.

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Characteristics and outcome of acute medical admissions with hyponatremia: even mild hyponatremia is associated with higher mortality

4th January 2018
PMID: 29300793
Authors Affiliations
Dorien A.W.A. Joosen Department of Internal Medicine, Division of General Medicine, Section Acute Medicine
N Anne Zwietering Maastricht University Medical Centre, Maastricht University, Maastricht, the Netherlands
Milou Bosch MD, Maastricht University Medical Centre, Maastricht University, Maastricht, the Netherlands
Patricia M. Stassen Maastricht University, CAPHRI School for Public Health and Primary Care, Ageing and Long-Term Care, 6229 ER Maastricht, the Netherlands.

Characteristics and outcome of acute medical admissions with hyponatremia: even mild hyponatremia is associated with higher mortality

Cite this article as:

Joosen DAWA, Zwietering NA, Bosch M, Stassen PM. Characteristics and outcome of acute medical admissions with hyponatremia: even mild hyponatremia is associated with higher mortality. Acute Med. 2017;16(4):156-163. PMID: 29300793.

Characteristics and outcome of acute medical admissions with hyponatremia: even mild hyponatremia is associated with higher mortality

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