Risk of adverse clinical outcomes in hyponatremic adult patients hospitalized for acute medical conditions. A population-based cohort study
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Authors
Kutz, Alexander
Ebrahimi, Fahim
Aghlmandi, Soheila
Bromley, Miluska
Illigens, Ben
Siepmann, Timo
Schuetz, Philipp
Mueller, Beat
Christ-Crain, Mirjam
Author (Corporation)
Publication date
2020
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Type
01A - Journal article
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Parent work
Journal of Clinical Endocrinology and Metabolism
Special issue
DOI of the original publication
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Series
Series number
Volume
105
Issue / Number
11
Pages / Duration
3428–3436
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Publisher / Publishing institution
Oxford University Press
Place of publication / Event location
Oxford
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Abstract
Hyponatremia has been associated with excess long-term morbidity and mortality. However, effects during hospitalization are poorly studied. Objective The objective of this work is to examine the association of hyponatremia with the risk of in-hospital mortality, 30-day readmission, and other short-term adverse events among medical inpatients. Design and Setting A population-based cohort study was conducted using a Swiss claims database of medical inpatients from January 2012 to December 2017 Patients Hyponatremic patients were 1:1 propensity-score matched with normonatremic medical inpatients. Main Outcome Measure The primary outcome was a composite of all-cause in-hospital mortality and 30-day hospital readmission. Secondary outcomes were intensive care unit (ICU) admission, intubation rate, length-of-hospital stay (LOS), and patient disposition after discharge. Results After matching, 94 352 patients were included in the cohort. Among 47 176 patients with hyponatremia, 8383 (17.8%) reached the primary outcome compared with 7994 (17.0%) in the matched control group (odds ratio [OR] 1.06 [95% CI, 1.02-1.10], P = .001). Hyponatremic patients were more likely to be admitted to the ICU (OR 1.43 [95% CI, 1.37-1.50], P < .001), faced a 56% increase in prolonged LOS (95% CI, 1.52-1.60, P < .001), and were admitted more often to a postacute care facility (OR 1.38 [95% CI 1.34-1.42, P < .001). Of note, patients with the syndrome of inappropriate antidiuresis (SIAD) had lower in-hospital mortality (OR 0.67 [95% CI, 0.56-0.80], P < .001) as compared with matched normonatremic controls. Conclusion In this study, hyponatremia was associated with increased risk of short-term adverse events, primarily driven by higher readmission rates, which was consistent among all outcomes except for decreased in-hospital mortality in SIAD patients.
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Subject (DDC)
330 - Wirtschaft
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ISBN
ISSN
0021-972X
Language
English
Created during FHNW affiliation
Yes
Strategic action fields FHNW
Publication status
Published
Review
Peer review of the complete publication
Open access category
Hybrid
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Citation
KUTZ, Alexander, Fahim EBRAHIMI, Soheila AGHLMANDI, Ulrich WAGNER, Miluska BROMLEY, Ben ILLIGENS, Timo SIEPMANN, Philipp SCHUETZ, Beat MUELLER und Mirjam CHRIST-CRAIN, 2020. Risk of adverse clinical outcomes in hyponatremic adult patients hospitalized for acute medical conditions. A population-based cohort study. Journal of Clinical Endocrinology and Metabolism. 2020. Bd. 105, Nr. 11, S. 3428–3436. DOI 10.1210/clinem/dgaa547. Verfügbar unter: https://doi.org/10.26041/fhnw-6832