Hyponatremia in Acute Stroke Patients: Pathophysiology, Clinical Significance, and Management Options

Liamis, Georgé; Barkas, Fotios; Megapanou, Efstathia; Christopoulou, Eliza; Makri, Andromachi; Makaritsis, Konstantinos; Ntaios, George; Elisaf, Moses; Milionis, Haralampos

doi:10.1159/000504475

Cited by 34 publications

(33 citation statements)

References 43 publications

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“…Many diseases have been associated with the onset of hyponatremia. It has been reported that pneumonia, heart failure, liver cirrhosis, malignant tumors, stroke, and other diseases are all prone to hyponatremia [ 26 – 30 ]. In our study, we analyzed the incidence of primary diseases in 4364 older patients with hyponatremia and identified respiratory diseases, tumors, cardiovascular diseases, central nervous system diseases, and orthopedic diseases as the most common, among which pulmonary infection, lung cancer, heart failure, cerebral infarction, and fracture accounted for the highest proportion.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of hyponatremia among older inpatients in a general hospital

Zhang

2020

Eur Geriatr Med

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Key Summary Points Aim This study aimed to explore the prevalence and the in-hospital mortality of hyponatremia in older inpatients who were diagnosed and treated at a single center. Findings Nearly a quarter of older inpatients presented with hyponatremia, which was most frequently associated with common primary diseases such as respiratory diseases, tumors, cardiovascular diseases, central nervous system diseases, and orthopedic diseases. Patients were most likely to use drugs such as PPIs, loop diuretics, potassium-preserving diuretics, ACEIs/ARBs, thiazide diuretics and NSAIDs, which were often associated with hyponatremia. The in-hospital mortality rate among patients with hyponatremia was 11.7%, and this rate increased with the severity of the disorder. Message Early mobilisation on the day of/after surgery should be added as a new formal hip fracture standard of care in keeping with best international practice.

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Section: Discussionmentioning

confidence: 99%

Prevalence of hyponatremia among older inpatients in a general hospital

Zhang

2020

Eur Geriatr Med

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“…The etiology of hyponatremia is complex, and there are many reasons why patients develop hyponatremia. Hyponatremia may arise in correlation with: (I) stroke and other primary mental primary diseases (7); (II) carbamazepine (8), cyclophosphamide, and selective serotonin reuptake inhibitors (SSRI) (9), exogenous hormones and other drugs; (III) primary tumors (10); (IV) hypophysis disease, hypothyroidism and adrenal insufficiency (11); (V) surgery;…”

Section: Development Of Hyponatremiamentioning

confidence: 99%

A narrative review of progress in diagnosis and treatment of small cell lung cancer patients with hyponatremia

Wu¹,

Li²,

Wang³

et al. 2020

Transl Lung Cancer Res

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Small cell lung cancer (SCLC) is one of the malignant cancers of lung tumors, and hyponatremia, defined as serum sodium concentration (Na + ) lower than 135 mmol/L, is the most common complication of solid tumors, with an incidence of up to 18.9% and a negative impact on quality of life in SCLC. As a prognostic index of SCLC, timely monitoring and correcting of hyponatremia is of great clinical significance for prolonging the survival period of patients. In the explore of new drugs for small cell lung cancer, it is necessary to include hyponatremia as an evaluation index in clinical studies. As the occurrence of hyponatremia is sometimes unavoidable owing to SCLC specific neurological characteristics, early monitoring to detect the presence of hyponatremia and timely correction are helpful to improve the prognosis of patients. There are many predisposing factors for hyponatremia, including heterotopia of antidiuretic hormone (ADH), use of platinum-based chemotherapy drugs, and intracranial metastasis, among others. Patients with small cell lung cancer are usually asymptomatic in the early stage, while it is of great significance to find a suitable clinical index to judge whether it is a malignant inducement or not.In the clinical setting, due to different electrolyte levels and therapeutic scheduling for the primary disease, an individualized plan is often made, mainly comprising water restriction, infusion, and medications. This review includes related clinical studies and describes the common symptoms and predisposing factors of hyponatremia in patients with SCLC, and their impact on quality of life and prognosis.

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“…Its prevalence varies from 8% to 51%, and it often occurs as an acute disease complication, as a chronic disease decompensation, or as a consequence of interventions during patient treatment [1,5,6]. Hyponatremia is a predictor of poor prognosis in various diseases, including heart failure, coronary syndrome, liver cirrhosis, chronic kidney disease, and stroke [3,5,[7][8][9]. It is featured on clinical assessment scales, such as APACHE (Acute Physiology and Chronic Health disease classification system) [10] and PSI (Pneumonia Severity Index) [11].…”

Section: Introductionmentioning

confidence: 99%

Impact of Hyponatremia on COPD Exacerbation Prognosis

García-Sanz¹,

Martínez-Gestoso²,

Calvo-Álvarez

et al. 2020

JCM

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The most common electrolyte disorder among hospitalized patients, hyponatremia is a predictor of poor prognosis in various diseases. The aim of this study was to establish the prevalence of hyponatremia in patients admitted for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), as well as its association with poor clinical progress. Prospective observational study carried out from 1 October 2016 to 1 October 2018 in the following hospitals: Salnés in Vilagarcía de Arousa, Arquitecto Marcide in Ferrol, and the University Hospital Complex of Santiago de Compostela, Galicia, Spain, on patients admitted for AECOPD. Patient baseline treatment was identified, including hyponatremia-inducing drugs. Poor progress was defined as follows: prolonged stay, death during hospitalization, or readmission within one month after the index episode discharge. 602 patients were enrolled, 65 cases of hyponatremia (10.8%) were recorded, all of a mild nature (mean 131.6; SD 2.67). Of all the patients, 362 (60%) showed poor progress: 18 (3%) died at admission; 327 (54.3%) had a prolonged stay; and 91 (15.1%) were readmitted within one month after discharge. Patients with hyponatremia had a more frequent history of atrial fibrillation (AF) (p 0.005), pleural effusion (p 0.01), and prolonged stay (p 0.01). The factors independently associated with poor progress were hyponatremia, pneumonia, and not receiving home O2 treatment prior to admission. Hyponatremia is relatively frequent in patients admitted for AECOPD, and it has important prognostic implications, even when mild in nature.

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Hyponatremia in Acute Stroke Patients: Pathophysiology, Clinical Significance, and Management Options

Cited by 34 publications

References 43 publications

Prevalence of hyponatremia among older inpatients in a general hospital

Prevalence of hyponatremia among older inpatients in a general hospital

A narrative review of progress in diagnosis and treatment of small cell lung cancer patients with hyponatremia

Impact of Hyponatremia on COPD Exacerbation Prognosis

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