Impact of Hyponatremia Correction on the Risk for 30-Day Readmission and Death in Patients with Congestive Heart Failure.
Am J Med. 2016 Mar 23;
Authors: Donzé JD, Beeler PE, Bates DW
OBJECTIVES: To compare the 30-day readmission rate and mortality between heart failure patients who have persistent hyponatremia during hospitalization and those who have their admission hyponatremia corrected before discharge.
METHODS: This large retrospective cohort study included all adult patients admitted with a diagnosis of congestive heart failure to a tertiary-care hospital between July 2003 and October 2009. We compared the readmission rate and mortality 30-day after discharge between patients with persistent hyponatremia (i.e. low sodium level at both admission and discharge) and patients with hyponatremia correction during hospitalization.
RESULTS: Among the 4,295 eligible patients with hyponatremia at admission, 1,799 (41.9%) did not have their sodium level corrected at discharge. Overall, 1,269 (29.5%) patients had a 30-day unplanned readmission or died. In a multivariable logistic regression analysis, the absence of hyponatremia correction was associated with a 45% increase in the odds of having a 30-day unplanned readmission or death (odds ratio 1.45; 95%CI [1.27-1.67]). Among patients with persistent hyponatremia, those with more severe hyponatremia at discharge (<130 mm/L) had a higher odds (odds ratio 1.68; 95%CI [1.32-2.14]) of having a 30-day readmission or death, than those with less severe hyponatremia at discharge (130-134 mm/L).
CONCLUSIONS: The absence of correction of hyponatremia over the course of hospitalization was frequent and independently associated with an increase of nearly 50% in the odds of having a 30-day unplanned readmission or death. This association appeared to be independent from heart failure severity.
PMID: 27019042 [PubMed - as supplied by publisher]