Prevalence and in-hospital mortality of hyponatremia: A cohort study

Elmi, Giovanna; Zaccaroni, Stefania; Arienti, Vincenzo; Faustini‐Fustini, Marco

doi:10.1016/j.ejim.2014.03.013

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…By meta‐analysing all available data, we recently demonstrated that even mild hyponatremia (serum [Na + ] 130‐135 mmol/L) is associated with a significantly increased risk of overall mortality independent of the primary causes underlying the reduction of serum [Na + ] . In addition, other authors have reported that chronic hyponatremia represents a poor prognostic factor in congestive heart failure, cirrhosis, pneumonia, hospitalized patients, in transplantation recipients and also in cancer patients…”

Section: Discussionmentioning

confidence: 99%

“…By meta-analysing all available data, we recently demonstrated that even mild hyponatremia (serum [Na + ] 130-135 mmol/L) is associated with a significantly increased risk of overall mortality independent of the primary causes underlying the reduction of serum [Na + ]. 38 In addition, other authors have reported that chronic hyponatremia represents a poor prognostic factor in congestive heart failure, 39 cirrhosis, 40 pneumonia, 41 hospitalized patients, 42 in transplantation recipients 43 and also in cancer patients 44,45 More recently, the association between hyponatremia and a higher risk of falls has emerged. Falls and hip fractures are common consequences of severe hyponatremia and usually a complication of hyponatremic encefalophaty with seizures.…”

Section: Discussionmentioning

confidence: 99%

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Hyponatremia, falls and bone fractures: A systematic review and meta‐analysis

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Parenti

et al. 2018

Clinical Endocrinology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hyponatremia, falls and bone fractures: A systematic review and meta‐analysis

Corona

Norello

Parenti

et al. 2018

Clinical Endocrinology

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“…Hyponatremia in hospitalized patients is common [ 1 , 36 ], and may increase the risk of mortality in various conditions. AKI is a common and dangerous, but correctable, disease.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Pre-Existing Hyponatremia and Subsequent-Developing Acute Kidney Injury on In-Hospital Mortality: A Retrospective Cohort Study

et al. 2016

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Background and ObjectivesBoth hyponatremia and acute kidney injury (AKI) are common and harmful in hospitalized patients. However, their combined effects on patient mortality have been little studied.MethodsWe retrospectively enrolled 19191 adult patients who were admitted for 1 year. Pre-existing hyponatremia was defined as a serum sodium level < 135 mmol/L on the first measurement of their admission. AKI was defined as a rise in serum creatinine by ≥ 26.5 μmol/L or ≥ 1.5 times of the baseline value of creatinine during the hospital stay.ResultsThe prevalence of pre-existing hyponatremia was 8.2%. During a median 6.0 days of hospital stay, the incidence rates of AKI and in-hospital patient mortality were 5.1% and 0.9%, respectively. Pre-existing hyponatremia independently predicted AKI development and in-hospital mortality (adjusted hazard ratio [HR] 1.300, P = 0.004; HR 2.481, P = 0.002, respectively). Pre-existing hyponatremia and subsequent development of AKI increased in-hospital mortality by 85 times, compared to the patients with normonatremia and no AKI. In subgroup analysis, the AKI group showed higher rates of de novo hypernatremia than the non-AKI group during the admission. De novo hypernatremia, which might be associated with over-correction of hyponatremia, increased in-hospital mortality (HR 3.297, P <0.001), and patients with AKI showed significantly higher rates of de novo hypernatremia than patients without AKI (16.2% vs. 1.4%, P < 0.001, respectively).ConclusionPre-existing hyponatremia may be associated with the development of AKI in hospitalized patients, and both hyponatremia and hospital-acquired AKI could have a detrimental effect on short term patient mortality, which might be related to the inappropriate correction of hyponatremia in AKI patients.

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“…Hyponatraemia is the most common electrolyte disorder observed in hospitalised patients and is closely associated with in-hospital mortality even in mild cases [ 1 – 9 ]. The high mortality rate associated with severe hyponatraemia suggests a causal relationship [ 4 , 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Prognosis of patients with severe hyponatraemia is related not only to hyponatraemia but also to comorbidities and to medical management: results of an observational retrospective study

et al. 2016

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BackgroundThe true cause of death in severe hyponatraemic patients remains controversial. The present study aimed to analyse the relationship between comorbidity, medical management and prognosis in severe hyponatraemic patients.MethodsMedical records of all patients hospitalised in our institution in 2012 with a plasma sodium ≤120 mmol/l were retrospectively analysed.ResultsOne hundred forty-seven of 64 723 adult patients (0.2 %) were identified with severe hyponatraemia. In-hospital mortality rate was 24.5 and 50.3 % after a median follow-up of 431 days. Patients with plasma sodium <110 mmol/l had less comorbidity (Charlson Comorbidity Index 2.2 ± 1.9 vs. 4.0 ± 3.1 (plasma sodium 110–115 mmol/l) and 4.2 ± 3.1 (plasma sodium 116–120 mmol/l); P = .02)) and a small trend for less mortality, respectively 40.0, 51.2 and 52.3 % (P = .64). At discharge, nonsurvivors and survivors had similar plasma sodium with 58.3 % of nonsurvivors being normonatraemic. Urine analysis was performed in 74.2 % of cases and associated with lower in-hospital mortality (20.2 % vs. 36.8 %, P = .05). In multivariate Cox analysis, mortality was significantly associated with plasma sodium normalisation (HR 0.35, P < 0.001), urine analysis (HR 0.48, P = .01), Charlson Comorbidity Index (HR 1.23, P < .001) and serum albumin (HR 0.88, P < .001).ConclusionMortality in severe hyponatraemia appears mainly due to comorbidities although the latter are potentiated by hyponatraemia itself and its management thereby exacerbating the risk of death.

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Prevalence and in-hospital mortality of hyponatremia: A cohort study

Cited by 6 publications

References 11 publications

Hyponatremia, falls and bone fractures: A systematic review and meta‐analysis

Hyponatremia, falls and bone fractures: A systematic review and meta‐analysis

The Effects of Pre-Existing Hyponatremia and Subsequent-Developing Acute Kidney Injury on In-Hospital Mortality: A Retrospective Cohort Study

Prognosis of patients with severe hyponatraemia is related not only to hyponatraemia but also to comorbidities and to medical management: results of an observational retrospective study

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