nach oben

Irish Journal of Medical Science (1971 -)

Erschienen in:

20.02.2022 | Original Article

Hyponatremia as a predictor of outcome and mortality: results from a second-level urban emergency department population

verfasst von: Anna Giulia Falchi, Camilla Mascolo, Vincenzo Sepe, Carmelo Libetta, Elisa Bonadeo, Riccardo Albertini, Federica Manzoni, Stefano Perlini

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Background

Hyponatremia is the most common electrolyte disorder and it has been associated with increased mortality.

Aims

This study evaluated hyponatremia as a prognostic factor for severity and mortality.

Methods

We compared the prevalence of hyponatremia among patients who died during the year 2017 (from 1 January 2017 to 31 December 2017) with the prevalence of hyponatremia among subgroups of patients, i.e. outpatients, patients hospitalized for more than 2 days and patients admitted in the intensive care unit (ICU). We also described the mortality rate and the prevalence of comorbidities among hyponatremic patients, according to hyponatremia degree (slight, moderate, severe), basal characteristics, comorbidities and their outcome (discharged, hospitalized or died).

Results

In our population of a public hospital setting, hyponatremia was present at admission in 17% of deaths, and the comparison between hyponatremic and normonatremic patients in terms of mortality confirms the hypothesis that this disorder is in anyway strictly associated with vulnerability and with a poor prognosis.

Conclusions

We conclude that hyponatremia is a predictive marker for a bad clinical course, therefore patients with this electrolyte disorder should be carefully monitored.

Asadollah K, Beeching N, Gill G (2006) Hyponatraemia as a risk factor for hospital mortality. QJMed 99(12):877–880. https://doi.org/10.1093/qjmed/hcl120CrossRef

Garrahy A, Cuesta M, Murphy B et al (2021) Active management of severe hyponatraemia is associated with improved mortality. CJ Eur J Endocrinol 184(1):9–17. https://doi.org/10.1530/EJE-20-0577

Baran D, Hutchinson TA (1984) The outcome of hyponatremia in a general hospital population. Clin Nephrol 72–76

Cuesta M, Garrahy A, Slattery D et al (2017) Mortality rates are lower in SIAD, than in hypervolaemic or hypovolaemic hyponatraemia: results of a prospective observational study. Clin Endocrinol (Oxf) 87(4):400–406. https://doi.org/10.1111/cen.13388. Epub 2017 Jul 13

Gill G, Huda B, Boyd A et al (2006) Characteristics and mortality of severe hyponatraemia: a hospital-based study. Clin Endocrinol (Oxf) 65(2):246–249. https://doi.org/10.1111/j.1365-2265.2006.02583.x

Hoorn EJ, Zietse R (2011) Hyponatremia and mortality: how innocent is the bystander? Clin J Am Soc Nephrol 6(5):951–953. https://doi.org/10.2215/CJN.01210211

Sajadieh A, Binici Z, Mouridsen MR et al (2009) Mild hyponatremia carries a poor prognosis in community subjects. Am J Med 122(7):679–686. https://doi.org/10.1016/j.amjmed.2008.11.033CrossRef

Bratusch-Marrain PR, DeFronzo RA (1983) Impairment of insulin-mediated glucose metabolism by hyperosmolality in man. Diabetes 32(11):1028–34. https://doi.org/10.2337/diab.32.11.1028

Kozeny GA, Murdock DK, Euler DE et al (1985) In vivo effects of acute changes in osmolality and sodium concentration on myocardial contractility. Am Heart J 109(2):290–296. https://doi.org/10.1016/0002-8703(85)90596-4CrossRef

10.

Chawla A, Sterns RH, Nigwekar SU et al (2011) Mortality and the serum sodium: do patients die with or from hyponatremia? Clin J Am Soc Nephrol 6(5):960–5. https://doi.org/10.2215/CJN.10101110

11.

Mohan S, Gu S, Parikh A et al (2013) Prevalence of hyponatremia and association with mortality: results from NHANES. Am J Med 126(12):1127–37.e1. https://doi.org/10.1016/j.amjmed.2013.07.021CrossRef

12.

Singla I, Zahid M, Good CB et al (2007) Effect of hyponatraemia on outcome in patients with non-ST-elevation acute coronary syndrome. Am J Cardiol 100(3):406–8. https://doi.org/10.1016/j.amjcard.2007.03.039

13.

Gheorghiade M, Rossi JS, Cotts W et al (2007) Characterization and prognostic value of persistent hyponatraemia in patients with severe heart failure in the ESCAPE trial. Arch Intern Med 167(18):1998–2005. https://doi.org/10.1001/archinte.167.18.1998CrossRef

14.

Heuman DM, Abou-Assi SG, Habib A et al (2004) Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology 40(4):802–10. https://doi.org/10.1002/hep.20405

15.

Kim DJ, Lee SK, Jo JW, Kim SJ et al (2006) Prognosis after liver transplantation predicted by preoperative MELD score. Transplant Proc 38(7):2095–2096. https://doi.org/10.1016/j.transproceed.2006.06.031CrossRef

16.

Biggins SW, Kim WR, Terrault NA et al (2006) Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology 130(6):1652–1660. https://doi.org/10.1053/j.gastro.2006.02.010CrossRef

17.

McCarthy K, Conway R, Byrne D et al (2019) Hyponatraemia during an emergency medical admission as a marker of illness severity & case complexity. Eur J Intern Med 59:60–64. https://doi.org/10.1016/j.ejim.2018.08.002CrossRef

18.

Vega J, Manríquez F, Madrid E et al (2011) Hyponatremia on admission to the emergency room as a risk factor for hospital mortality. Rev Med Chil 139(8):985–91

19.

World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects (2013) JAMA 310(20):2191–4. https://doi.org/10.1001/jama

20.

Ball S, Barth J, Levy M, Society for Endocrinology Clinical Committee (2016) Society for endocrinology endocrine emergency guidance: emergency management of severe symptomatic hyponatraemia in adult patients. Endocr Connect 5(5):G4–G6. https://doi.org/10.1530/EC-16-0058CrossRef

21.

Istituto Nazionale di Statistica ISTAT (2012) ISTAT, https://www.istat.it/it/files//2011/01/D4bis_2012.pdf

22.

Hao J, Li Y, Zhang X, Pang C et al (2017) The prevalence and mortality of hyponatremia is seriously underestimated in Chinese general medical patients: an observational retrospective study. BMC Nephrol 18(1):328. https://doi.org/10.1186/s12882-017-0744-xCrossRef

23.

Zheng Y, Zheng FP, Li H (2020) Zhonghua Nei Ke Za Zhi. 59(1):29–34. https://doi.org/10.3760/cma.j.issn.0578-1426.2020.01.005

24.

Balling L, Schou M, Videbæk L et al (2011) Prevalence and prognostic significance of hyponatraemia in outpatients with chronic heart failure. Eur J Heart Fail 13(9):968–73. https://doi.org/10.1093/eurjhf/hfr086

25.

Bennani SL , Abouqal R, Zeggwagh AA et al (2003) Incidence, causes and prognostic factors of hyponatremia in intensive care. Rev Med Interne 24(4):224–9. https://doi.org/10.1016/s0248-8663(02)00811-1

26.

Elmi G, Faustini-Fustini M, Zaccaroni S et al (2011) The hyponatremias. Ital J Med 5(3):156–68

27.

Waikar SS, Mount DB, Curhan GC (2009) Mortality after hospitalization with mild, moderate, and severe hyponatremia Am J Med 122(9):857–65. https://doi.org/10.1016/j.amjmed.2009.01.027

28.

Holland-Bill L, Christiansen CF, Heide-Jørgensen U et al (2005) Hyponatremia and mortality risk: a Danish cohort study of 279 508 acutely hospitalized patients. Eur J Endocrinol 173(1):71–81. https://doi.org/10.1530/EJE-15-0111

Titel: Hyponatremia as a predictor of outcome and mortality: results from a second-level urban emergency department population
verfasst von: Anna Giulia Falchi
Camilla Mascolo
Vincenzo Sepe
Carmelo Libetta
Elisa Bonadeo
Riccardo Albertini
Federica Manzoni
Stefano Perlini
Publikationsdatum: 20.02.2022
Verlag: Springer International Publishing
Erschienen in: Irish Journal of Medical Science (1971 -) / Ausgabe 1/2023
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-022-02953-8

The therapeutic effect of co-administration of pentoxifylline and zinc in men with idiopathic infertility

Original Article

Correction to: The reporting standards of randomised controlled trials in leading medical journals between 2019 and 2020: a systematic review

Open Access
Correction

Can smoking cause impotence? a radiological retrospective cohort study comparing internal pudendal artery calcification on CT in male smokers versus non-smokers

Open Access
Original Article

Correction to: Competencies required for graduated physicians: the integration of Englander’s common taxonomy in a validated scale for the assessment of competency acquiring in undergraduate medical education

Correction

Impact of haemoglobin variants on the use of haemoglobin A1c for the diagnosis and monitoring of diabetes: a contextualised review

Open Access
Review Article

Minor surgery in primary care has reduced minor surgery waiting lists: a 12-month review

Open Access
Original Article

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

ctDNA erkennt minimale Resterkrankung beim Melanom

25.04.2025
Tumormarker
Nachrichten

Die Diagnose einer minimalen Resterkrankung mithilfe zirkulierender Tumor-DNA könnte (ctDNA) auch das Management von Patientinnen und Patienten mit Melanomen im Stadium III bereichern, wie Ergebnisse einer Studie nahelegen – auch wenn die Methode noch nicht perfekt funktioniert.

Lipidtherapie im Praxisalltag: Noch viel Spielraum für Verbesserung

25.04.2025
DGK-Jahrestagung 2025
Kongressbericht

Wie steht es um die Behandlung von Dyslipidämien bei Risikopatienten mit atherosklerotischer Gefäßerkrankung in Deutschland? Eine Bestandsaufnahme dazu liefert das bei der DGK-Tagung 2025 vorgestellte Forschungsprojekt LipidSnapshot.

Lohnt sich die Karotis-Revaskularisation?

25.04.2025
Karotisstenose
Nachrichten

Die medikamentöse Therapie für Menschen mit Karotisstenosen hat sich in den vergangenen Dekaden verbessert. Braucht es also noch einen invasiven Eingriff zur Revaskularisation der Halsschlagader bei geringem bis moderatem Risiko für einen ipsilateralen Schlaganfall?

Höhere Dosis von Dexamethason senkt Überlebenschancen

25.04.2025
Zerebrale Metastasen
Nachrichten

Personen mit Hirnmetastasen, die perioperativ höhere kumulative Dosen von Dexamethason erhalten, haben eine schlechtere Prognose. Um die Ergebnisse zu verbessern, bedarf es strengerer Dosierungsschemata.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Jetzt 10 CME-Punkte sammeln

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Hyponatremia as a predictor of outcome and mortality: results from a second-level urban emergency department population