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

11 Scopus citations

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

ASJC Scopus subject areas

  • Medicine(all)

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    Geoghegan, P., Harrison, A. M., Thongprayoon, C., Kashyap, R., Ahmed, A., Dong, Y., Rabinstein, A., Kashani, K. B., & 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