Hyponatraemia is an independent predictor of in-hospital mortality.

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Hyponatraemia is an independent predictor of in-hospital mortality.

Eur J Intern Med. 2014 Feb 26;

Authors: Sturdik I, Adamcova M, Kollerova J, Koller T, Zelinkova Z, Payer J

Abstract
BACKGROUND: Hyponatraemia increases morbidity and mortality, but the extent to which this condition influences mortality independently of other contributing factors is unclear.
MATERIALS AND METHODS: All hyponatremic patients admitted to the internal medicine department during a six month period were included. Medical records were reviewed and patients' demographics, underlying disease, cause of hyponatremia and in-hospital deaths were noted. Control group consisted of patients with normonatremia admitted to the same department during the same period matched 1:1 by sex, age and underlying disease. Difference in in-hospital mortality rate between the study and control groups was tested by chi-square test. Baseline demographics, underlying diseases, cause of hyponatremia and state of hyponatremia correction as possible risk factors for mortality were tested in a multivariate analysis.
RESULTS: The baseline cohort of all admitted patients consisted of 2171 patients. Hyponatraemia was found in 278 (13%) patients (160 females and 118 males). The three most common causes of hyponatremia included gastrointestinal loss (52 patients), decreased oral intake (47 patients), and dilution hyponatremia (45 patients). The in-hospital mortality rate in the hyponatremic group was significantly higher compared with the control group (22% vs 7%, respectively; OR 3.75, 95% CI 2.17-6.48, p<0.0001). In a multivariate analysis age above 65years, dilution hyponatremia, decreased oral intake as etiologic factors of hyponatremia, and unsuccessful hyponatremia correction were independent factors associated with increased mortality.
CONCLUSION: Hyponatraemia represents independent factor associated with in-hospital mortality. Age above 65years, failure to correct hyponatremia and some specific etiologic factors of hyponatremia are related to increased mortality.

PMID: 24582329 [PubMed - as supplied by publisher]

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