Prévalence, facteurs de risque et signification pronostique de l’hypernatrémie lors d’une hospitalisation en médecine interne

Lopes, I. Felizardo; Dezelée, S.; Rodrigues, Nicollas Garcia; Brault, D.; Steichen, Olivier

doi:10.1016/j.revmed.2014.03.099

Cited by 2 publications

(4 citation statements)

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“…Our findings for increment of in-hospital mortality along with the increase in the severity of hypernatremia are similar to other studies. 1,4,7,9–11,23 In line with our results, previous studies by Hu et al 7,23 in China and Funk et al 12 in Austria demonstrated that there are independent associations between hypernatremia and the risk of in-hospital mortality even after adjusting for potential confounding factors. This is especially true for patients admitted with dysnatremias in the intensive care unit.…”

Section: Discussionsupporting

confidence: 92%

“…Finally, hypernatremia is frequently associated with increased extracellular fluid volume, even outside intensive care units. 9…”

Section: Discussionmentioning

confidence: 99%

“…4–7 Outcomes of hypernatremia have also been less studied, and most studies examined selected patient populations. 1,4,8–10 In addition, there are limited studies regarding hospital-acquired hypernatremia 11 and patients' kidney function at admission.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Hospital-Acquired Hypernatremia

Arzhan,

Roumelioti,

Litvinovich

et al. 2023

CJASN

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Background Hospital-acquired hypernatremia is highly prevalent, overlooked and is associated with unfavorable consequences. There are limited studies examining the outcomes and discharge dispositions of various levels of hospital-acquired hypernatremia in patients with or without chronic kidney disease. Methods We conducted an observational retrospective cohort study, and we analyzed the data of 1,728,141 million patients extracted from the Cerner Health Facts database (January 1st 2000- June 30th 2018). In this report we investigated the association between hospital-acquired hypernatremia (serum sodium (Na) levels>145 mEq/L) and in-hospital mortality or discharge dispositions with kidney function status at admission using adjusted multinomial regression models. Results Of all hospitalized patients, 6% developed hypernatremia after hospital admission. Incidence of in-hospital mortality was 12% and 1% in hyper- and normonatremic patients, respectively. The risk of all outcomes was significantly greater for serum Na >145 mEq/L compared to the reference interval (serum Na: 135-145 mEq/L). In hypernatremic patients, odds ratios (ORs) (95% confidence interval) for in-hospital mortality, discharge to hospice and discharge to nursing facilities were 14.04 (13.71-14.38), 4.35 (4.14-4.57) and 3.88 (3.82-3.94), respectively (p<0.001, for all). Patients with estimated glomerular filtration rate (CKD-EPI) 60-89 mL/min/1.73 m2 and normonatremia had the lowest OR for in-hospital mortality (1.60 [1.52-1.70]) Conclusions Hospital-acquired hypernatremia is associated with in-hospital mortality as well as discharge to hospice or to nursing facility in all stages of CKD.

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Section: Discussionsupporting

confidence: 92%

“…Finally, hypernatremia is frequently associated with increased extracellular fluid volume, even outside intensive care units. 9…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Hospital-Acquired Hypernatremia

Arzhan,

Roumelioti,

Litvinovich

et al. 2023

CJASN

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“…In 2015, a retrospective analysis [ 18 ] compared the outcomes of hypernatremic patients with those of all other subjects. The data were collected from a single 36-bed department of internal medicine over a period of 28 months, totaling 1,945 hospitalizations.…”

Section: Hypernatremia: Epidemiology and Outcomesmentioning

confidence: 99%

Hypernatremia: Epidemiology and Predictive Role in Emerging and Established Acute Kidney Injury

Jansch,

Matyukhin,

Marahrens

et al. 2023

J Clin Med Res

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Hypernatremia (plasma sodium > 145 mmol/L) reflects impaired water balance, and affected patients can suffer from severe neurologic symptoms. Hyponatremia, on the other hand, is the most frequent electrolyte disorder in hospitals. It may be diagnosed in acute kidney injury (AKI), but hyponatremia prior to the diagnosis of AKI has also predictive or prognostic value in the short term. Aim of the article was to summarize data on both, epidemiology and outcomes of in-hospital acquired hypernatremia (“In-hospital acquired” refers to the diagnosis of either hypo- or hypernatremia in patients, who did not exhibit any of these electrolyte imbalances upon admission to the hospital). It also aimed to discuss its predictive role in patients with emerging or established AKI. Five databases were searched for references: PubMed, Medline, Google Scholar, Scopus, and Cochrane Library. Studies published between 2000 and 2023 were screened. The following keywords were used: “hypernatremia”, “mortality”, “pathophysiology”, “acute kidney injury”, “AKI”, “risk prediction”, “kidney replacement therapy”, “KRT”, “renal replacement therapy”, “RRT”, “hyponatremia”, and “heart failure”. A total of 16 studies were deemed eligible for inclusion. Among these, 13 studies had a retrospective design, two investigations were published as secondary analyses from prospective trial cohorts, and one study was prospective in nature. Out of the 16 studies, 11 focused on the epidemiology and outcomes of hypernatremia, while five investigations were related to AKI and/or AKI-associated endpoints. The prevalence of hypernatremia diagnosed during hospitalization varied from 1.9% to 6.8%, with one exception where it was 30.8%. All studies demonstrated associations between hypernatremia and mortality, even over extended periods after discharge. In AKI patients, hypernatremia shows potential for predicting in-hospital death. In conclusion, hypernatremic individuals are at higher risk of death during in-hospital therapy. Also, the electrolyte disorder potentially qualifies as a future biomarker for AKI onset and AKI-associated mortality.

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Prévalence, facteurs de risque et signification pronostique de l’hypernatrémie lors d’une hospitalisation en médecine interne

Cited by 2 publications

References 0 publications

Outcomes of Hospital-Acquired Hypernatremia

Outcomes of Hospital-Acquired Hypernatremia

Hypernatremia: Epidemiology and Predictive Role in Emerging and Established Acute Kidney Injury

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