Sodium Correction Practice and Clinical Outcomes in Profound Hyponatremia

Pierce Geoghegan, Andrew M. Harrison, Charat Thongprayoon, Rahul Kashyap, Adil Ahmed, Yue Dong, Alejandro Rabinstein, Kianoush B. Kashani, Ognjen Gajic

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives To assess the epidemiology of nonoptimal hyponatremia correction and to identify associated morbidity and in-hospital mortality. Patients and Methods An electronic medical record search identified all patients admitted with profound hyponatremia (sodium 2 test for categorical variables. Odds ratios for in-hospital mortality between groups were assessed using logistic regression. Adjusted differences in hospital length of stay (LOS) and intensive care unit (ICU) LOS were assessed using the Dunnett 2-tailed t test. Results A total of 412 patients satisfied inclusion criteria of whom 174 (42.2%) were admitted to the ICU. A total of 211 (51.2%) had optimal correction of their hyponatremia at 24 hours, 87 (21.1%) had undercorrected hyponatremia, and 114 (27.9%) had overcorrected hyponatremia. Both patient factors and treatment factors were associated with nonoptimal correction. There was a single case of ODS. Overcorrection was not associated with in-hospital mortality or ICU LOS. When adjusted for patient factors, undercorrection of profound hyponatremia was associated with an increase in hospital LOS (9.3 days; 95% CI, 1.9-16.7 days). Conclusion Nonoptimal correction of profound hyponatremia is common. Fortunately, nonoptimal correction is associated with serious morbidity only infrequently.

Original languageEnglish (US)
Pages (from-to)1348-1355
Number of pages8
JournalMayo Clinic Proceedings
Volume90
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Hyponatremia
Sodium
Length of Stay
Hospital Mortality
Intensive Care Units
Morbidity
Electronic Health Records
Epidemiology
Logistic Models
Odds Ratio

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Geoghegan, P., Harrison, A. M., Thongprayoon, C., Kashyap, R., Ahmed, A., Dong, Y., ... Gajic, O. (2015). Sodium Correction Practice and Clinical Outcomes in Profound Hyponatremia. Mayo Clinic Proceedings, 90(10), 1348-1355. https://doi.org/10.1016/j.mayocp.2015.07.014

Sodium Correction Practice and Clinical Outcomes in Profound Hyponatremia. / Geoghegan, Pierce; Harrison, Andrew M.; Thongprayoon, Charat; Kashyap, Rahul; Ahmed, Adil; Dong, Yue; Rabinstein, Alejandro; Kashani, Kianoush B.; Gajic, Ognjen.

In: Mayo Clinic Proceedings, Vol. 90, No. 10, 01.10.2015, p. 1348-1355.

Research output: Contribution to journalArticle

Geoghegan, P, Harrison, AM, Thongprayoon, C, Kashyap, R, Ahmed, A, Dong, Y, Rabinstein, A, Kashani, KB & Gajic, O 2015, 'Sodium Correction Practice and Clinical Outcomes in Profound Hyponatremia', Mayo Clinic Proceedings, vol. 90, no. 10, pp. 1348-1355. https://doi.org/10.1016/j.mayocp.2015.07.014
Geoghegan P, Harrison AM, Thongprayoon C, Kashyap R, Ahmed A, Dong Y et al. Sodium Correction Practice and Clinical Outcomes in Profound Hyponatremia. Mayo Clinic Proceedings. 2015 Oct 1;90(10):1348-1355. https://doi.org/10.1016/j.mayocp.2015.07.014
Geoghegan, Pierce ; Harrison, Andrew M. ; Thongprayoon, Charat ; Kashyap, Rahul ; Ahmed, Adil ; Dong, Yue ; Rabinstein, Alejandro ; Kashani, Kianoush B. ; Gajic, Ognjen. / Sodium Correction Practice and Clinical Outcomes in Profound Hyponatremia. In: Mayo Clinic Proceedings. 2015 ; Vol. 90, No. 10. pp. 1348-1355.
@article{b88227e210b147eca716df5c4d5bb73c,
title = "Sodium Correction Practice and Clinical Outcomes in Profound Hyponatremia",
abstract = "Objectives To assess the epidemiology of nonoptimal hyponatremia correction and to identify associated morbidity and in-hospital mortality. Patients and Methods An electronic medical record search identified all patients admitted with profound hyponatremia (sodium 2 test for categorical variables. Odds ratios for in-hospital mortality between groups were assessed using logistic regression. Adjusted differences in hospital length of stay (LOS) and intensive care unit (ICU) LOS were assessed using the Dunnett 2-tailed t test. Results A total of 412 patients satisfied inclusion criteria of whom 174 (42.2{\%}) were admitted to the ICU. A total of 211 (51.2{\%}) had optimal correction of their hyponatremia at 24 hours, 87 (21.1{\%}) had undercorrected hyponatremia, and 114 (27.9{\%}) had overcorrected hyponatremia. Both patient factors and treatment factors were associated with nonoptimal correction. There was a single case of ODS. Overcorrection was not associated with in-hospital mortality or ICU LOS. When adjusted for patient factors, undercorrection of profound hyponatremia was associated with an increase in hospital LOS (9.3 days; 95{\%} CI, 1.9-16.7 days). Conclusion Nonoptimal correction of profound hyponatremia is common. Fortunately, nonoptimal correction is associated with serious morbidity only infrequently.",
author = "Pierce Geoghegan and Harrison, {Andrew M.} and Charat Thongprayoon and Rahul Kashyap and Adil Ahmed and Yue Dong and Alejandro Rabinstein and Kashani, {Kianoush B.} and Ognjen Gajic",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.mayocp.2015.07.014",
language = "English (US)",
volume = "90",
pages = "1348--1355",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "10",

}

TY - JOUR

T1 - Sodium Correction Practice and Clinical Outcomes in Profound Hyponatremia

AU - Geoghegan, Pierce

AU - Harrison, Andrew M.

AU - Thongprayoon, Charat

AU - Kashyap, Rahul

AU - Ahmed, Adil

AU - Dong, Yue

AU - Rabinstein, Alejandro

AU - Kashani, Kianoush B.

AU - Gajic, Ognjen

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Objectives To assess the epidemiology of nonoptimal hyponatremia correction and to identify associated morbidity and in-hospital mortality. Patients and Methods An electronic medical record search identified all patients admitted with profound hyponatremia (sodium 2 test for categorical variables. Odds ratios for in-hospital mortality between groups were assessed using logistic regression. Adjusted differences in hospital length of stay (LOS) and intensive care unit (ICU) LOS were assessed using the Dunnett 2-tailed t test. Results A total of 412 patients satisfied inclusion criteria of whom 174 (42.2%) were admitted to the ICU. A total of 211 (51.2%) had optimal correction of their hyponatremia at 24 hours, 87 (21.1%) had undercorrected hyponatremia, and 114 (27.9%) had overcorrected hyponatremia. Both patient factors and treatment factors were associated with nonoptimal correction. There was a single case of ODS. Overcorrection was not associated with in-hospital mortality or ICU LOS. When adjusted for patient factors, undercorrection of profound hyponatremia was associated with an increase in hospital LOS (9.3 days; 95% CI, 1.9-16.7 days). Conclusion Nonoptimal correction of profound hyponatremia is common. Fortunately, nonoptimal correction is associated with serious morbidity only infrequently.

AB - Objectives To assess the epidemiology of nonoptimal hyponatremia correction and to identify associated morbidity and in-hospital mortality. Patients and Methods An electronic medical record search identified all patients admitted with profound hyponatremia (sodium 2 test for categorical variables. Odds ratios for in-hospital mortality between groups were assessed using logistic regression. Adjusted differences in hospital length of stay (LOS) and intensive care unit (ICU) LOS were assessed using the Dunnett 2-tailed t test. Results A total of 412 patients satisfied inclusion criteria of whom 174 (42.2%) were admitted to the ICU. A total of 211 (51.2%) had optimal correction of their hyponatremia at 24 hours, 87 (21.1%) had undercorrected hyponatremia, and 114 (27.9%) had overcorrected hyponatremia. Both patient factors and treatment factors were associated with nonoptimal correction. There was a single case of ODS. Overcorrection was not associated with in-hospital mortality or ICU LOS. When adjusted for patient factors, undercorrection of profound hyponatremia was associated with an increase in hospital LOS (9.3 days; 95% CI, 1.9-16.7 days). Conclusion Nonoptimal correction of profound hyponatremia is common. Fortunately, nonoptimal correction is associated with serious morbidity only infrequently.

UR - http://www.scopus.com/inward/record.url?scp=84955377468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84955377468&partnerID=8YFLogxK

U2 - 10.1016/j.mayocp.2015.07.014

DO - 10.1016/j.mayocp.2015.07.014

M3 - Article

C2 - 26434962

AN - SCOPUS:84955377468

VL - 90

SP - 1348

EP - 1355

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 10

ER -