Prognosis of patients with severe hyponatraemia is related not only to hyponatraemia but also to comorbidities and to medical management: ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-10-22

AUTHORS

Thierry Krummel, Eric Prinz, Marie-Astrid Metten, Claire Borni-Duval, Dorothée Bazin-Kara, Emmanuelle Charlin, Jean-Marc Lessinger, Thierry Hannedouche

ABSTRACT

BACKGROUND: The 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. METHODS: Medical records of all patients hospitalised in our institution in 2012 with a plasma sodium ≤120 mmol/l were retrospectively analysed. RESULTS: One 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). CONCLUSION: Mortality 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. More... »

PAGES

159

References to SciGraph publications

  • 1986-11. The prognosis of hyponatremia at hospital admission in JOURNAL OF GENERAL INTERNAL MEDICINE
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    URI

    http://scigraph.springernature.com/pub.10.1186/s12882-016-0370-z

    DOI

    http://dx.doi.org/10.1186/s12882-016-0370-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1007802751

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27770791


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