Prognostic consequences of borderline dysnatremia: pay attention to minimal serum sodium change View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-02

AUTHORS

Michael Darmon, Eric Diconne, Bertrand Souweine, Stéphane Ruckly, Christophe Adrie, Elie Azoulay, Christophe Clec'h, Maïté Garrouste-Orgeas, Carole Schwebel, Dany Goldgran-Toledano, Hatem Khallel, Anne-Sylvie Dumenil, Samir Jamali, Christine Cheval, Bernard Allaouchiche, Fabrice Zeni, Jean-François Timsit

ABSTRACT

INTRODUCTION: To assess the prevalence of dysnatremia, including borderline changes in serum sodium concentration, and to estimate the impact of these dysnatremia on mortality after adjustment for confounders. METHODS: Observational study on a prospective database fed by 13 intensive care units (ICUs). Unselected patients with ICU stay longer than 48 h were enrolled over a 14-year period were included in this study. Mild to severe hyponatremia were defined as serum sodium concentration < 135, < 130, and < 125 mmol/L respectively. Mild to severe hypernatremia were defined as serum sodium concentration > 145, > 150, and > 155 mmol/L respectively. Borderline hyponatremia and hypernatremia were defined as serum sodium concentration between 135 and 137 mmol/L or 143 and 145 respectively. RESULTS: A total of 11,125 patients were included in this study. Among these patients, 3,047 (27.4%) had mild to severe hyponatremia at ICU admission, 2,258 (20.3%) had borderline hyponatremia at ICU admission, 1,078 (9.7%) had borderline hypernatremia and 877 (7.9%) had mild to severe hypernatremia. After adjustment for confounder, both moderate and severe hyponatremia (subdistribution hazard ratio (sHR) 1.82, 95% CI 1.002 to 1.395 and 1.27, 95% CI 1.01 to 1.60 respectively) were associated with day-30 mortality. Similarly, mild, moderate and severe hypernatremia (sHR 1.34, 95% CI 1.14 to 1.57; 1.51, 95% CI 1.15 to 1.99; and 2.64, 95% CI 2.00 to 3.81 respectively) were independently associated with day-30 mortality. CONCLUSIONS: One-third of critically ill patients had a mild to moderate dysnatremia at ICU admission. Dysnatremia, including mild changes in serum sodium concentration, is an independent risk factor for hospital mortality and should not be neglected. More... »

PAGES

r12

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/cc11937

DOI

http://dx.doi.org/10.1186/cc11937

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1024665243

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23336363


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