Risk of adverse clinical outcomes in hyponatremic adult patients hospitalized for acute medical conditions. A population-based cohort study
Loading...
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
Typ of student thesis
Course of study
Collections
Type
01A - Journal article
Editors
Editor (Corporation)
Supervisor
Parent work
Journal of Clinical Endocrinology and Metabolism
Special issue
DOI of the original publication
Link
Series
Series number
Volume
105
Issue / Number
11
Pages / Duration
3428–3436
Patent number
Publisher / Publishing institution
Oxford University Press
Place of publication / Event location
Oxford
Edition
Version
Programming language
Assignee
Practice partner / Client
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.
Keywords
Subject (DDC)
330 - Wirtschaft
Event
Exhibition start date
Exhibition end date
Conference start date
Conference end date
Date of the last check
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
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