Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study

Zilberberg, Marya D.; Exuzides, Alex; Spalding, James; Foreman, Aimee J.; Jones, Alison Graves; Colby, Chris; Shorr, Andrew F.

doi:10.1186/1471-2466-8-16

Cited by 129 publications

(111 citation statements)

References 25 publications

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“…16 Likewise, a study by Zilberberg and colleagues reported no significant increased risk of death with hyponatremia compared with normonatremia. 4 These results are similar to our results for all-cause hyponatremia and for hyponatremia subgrouped by severity. In contrast, a study by Nair and colleagues reported some increased risk of death with hyponatremia.…”

Section: Discussionsupporting

confidence: 82%

“…2 Previous studies have suggested that the presence and degree of hyponatremia is associated with the severity of pneumonia in adults and children, although the results have differed among studies. [3][4][5][6][7] Hyponatremia is caused by various factors, including volume depletion, use of diuretics, hypothyroidism, adrenal insufficiency, heart failure, renal failure, and cirrhosis. Additionally, the syndrome of inappropriate antidiuresis (SIAD) is a frequent and heterogeneous disorder characterized by hyponatremia and impaired urinary dilution in the absence of any recognized stimulation of antidiuretic hormone secretion.…”

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confidence: 99%

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Impact of hyponatremia and the syndrome of inappropriate antidiuresis on mortality in elderly patients with aspiration pneumonia

Miyashita

Shimada

Hunter

et al. 2012

Journal of Hospital Medicine

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BACKGROUND:Hyponatremia is associated with pneumonia, and aspiration pneumonia is common in the elderly, however, there has been no study of hyponatremia in this population.OBJECTIVE:To determine the impact of hyponatremia on mortality in elderly patients with aspiration pneumonia, while focusing on the comparison between those with and without the syndrome of inappropriate antidiuresis (SIAD).DESIGN:Retrospective review of existing database and medical records.SETTING:A community teaching hospital in Japan.PATIENTS:Two hundred and twenty‐one elderly patients hospitalized with aspiration pneumonia.MEASUREMENTS:Multivariate logistical regression models were used to compare 30‐day and in‐hospital mortality, in patients with hyponatremia of various severities and etiologies, with that in patients with normal serum sodium concentrations.RESULTS:Sixty‐five (29%) of 221 patients had hyponatremia. Of these 62 (95%) had hypotonic hyponatremia, which were further assessed as having hypovolemic (39 [63%]), hypervolemic (3 [5%]), and euvolemic (20 [32%]) hyponatremia. Of the 20 euvolemic patients, 14 (70%) had SIAD. Both moderate and severe hypotonic hyponatremia were significantly associated with increased in‐hospital mortality (odds ratio [OR] 6.05, 95% confidence interval [CI] 1.46–25.0, and OR 5.65, 95% CI 1.14–28.1, respectively). Hyponatremia due to SIAD was significantly associated with both increased 30‐day mortality (OR 7.40, 95% CI 1.73–31.7) and increased in‐hospital mortality (OR 22.3, 95% CI 4.26–117). In contrast, hypovolemic hyponatremia was not significantly associated with increased mortality.CONCLUSIONS:Hyponatremia due to SIAD was strongly associated with increased mortality in elderly patients with aspiration pneumonia, whereas hypovolemic hyponatremia was not associated with increased mortality. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Impact of hyponatremia and the syndrome of inappropriate antidiuresis on mortality in elderly patients with aspiration pneumonia

Miyashita

Shimada

Hunter

et al. 2012

Journal of Hospital Medicine

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“…In the study by Zilberberg et al, the frequency of hyponatraemia that accompanies community acquired pneumonia was estimated at 8.1%. They observed longer hospital stays in these patients, higher frequency of hospitalization in intensive care units, and mechanical ventilation [16]. However, no statistically significant difference was found (similarly as in the previously mentioned studies by Waikar et al [11]) in the frequency of in-hospital deaths in these patients.…”

Section: Discussioncontrasting

confidence: 36%

Hyponatraemia—Evaluation of Prevalence in Patients Hospitalized in the Pulmonary Department and Prognostic Significance in Lung Cancer Patients

Zarzecka

Kubicki²,

Kozielski³

2013

Advances in Respiratory Medicine

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Introduction: It is known from clinical practice that data concerning plasma sodium concentration and its influence on patient prognosis are underestimated. The aim of this study was the evaluation of the prevalence and influence of hyponatraemia on prognosis in patients with lung diseases, particularly with lung cancer. Material and methods: Retrospective analysis of data obtained from a single Pulmonary Department was performed. A total of 449 patients divided in two groups, were analysed. The first group consisted of all lung cancer patients (n = 290) hospitalized in the analysed period. The second group included patients with hyponatraemia but without diagnosed lung cancer (n = 159). The prevalence of hyponatraemia, including severity (mild, moderate or severe), was evaluated. Histological types of lung cancer as well as comorbidities were taken into account. Results: Hyponatraemia was found in 46.9% of patients with lung cancer, including mild (serum sodium 135-130 mEq/L), moderate (129-125 mEq/L) and severe hyponatraemia (< 125 mEq/L) in 66.9%, 25% and 8.1, respectively. In patients without lung cancer and with recognized hyponatraemia, mild, moderate and severe hyponatraemia were found in 81.8%, 13.2% and 5%, respectively (mainly in obstructive and interstitial lung diseases). Hyponatraemia was observed in 52.6% of patients with non-small cell lung cancer (NSCLC) and in 45.2% of patients with small cell lung cancer (SCLC). There was no statistical significance in prevalence of hyponatraemia between histological types of lung cancer. In patients with lung cancer and hyponatraemia compared to patients with lung cancer but without hyponatraemia, a significant increase of in-hospital mortality was found (28.7% vs. 7.8%, respectively) p < 0.001. Conclusions: Hyponatraemia was a common abnormality found in approximately 50% of lung cancer patients. Hyponatraemia was a significant prognostic factor associated with poor prognosis.

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“…34 Zilberberg et al reported that hyponatremia was associated with increased mortality. 35 We did not find any significant effect of laboratory parameters (Na, BUN, albumin, creatinine, hemoglobin, WBC and CRP) on mortality.…”

mentioning

confidence: 73%

Multidrug Resistance Among A. baumannii Isolates from Intensive Care Unit: A Four Years Retrospective Study

Doruk¹,

Köseoğlu²,

Yenişehirli³

et al. 2016

Turkiye Klinikleri Arch Lung

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Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study

Abstract: Background: Community-acquired (CAP) and nosocomial pneumonias contribute substantially to morbidity and hospital resource utilization. Hyponatremia, occurring in >1/4 of patients with CAP, is associated with greater disease severity and worsened outcomes.

Cited by 129 publications

References 25 publications

Impact of hyponatremia and the syndrome of inappropriate antidiuresis on mortality in elderly patients with aspiration pneumonia

Impact of hyponatremia and the syndrome of inappropriate antidiuresis on mortality in elderly patients with aspiration pneumonia

Hyponatraemia—Evaluation of Prevalence in Patients Hospitalized in the Pulmonary Department and Prognostic Significance in Lung Cancer Patients

Multidrug Resistance Among A. baumannii Isolates from Intensive Care Unit: A Four Years Retrospective Study

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