Hyponatraemia at hospital admission is a predictor of overall mortality

L Balling; F Gustafsson; J P Goetze; M Dalsgaard; H Nielsen; S Boesgaard; M Bay; V Kirk; O W Nielsen; L Køber; K Iversen

doi:10.1111/imj.12623

Hyponatraemia at hospital admission is a predictor of overall mortality

L Balling, F Gustafsson, J P Goetze, M Dalsgaard, H Nielsen, S Boesgaard, M Bay, V Kirk, O W Nielsen, L Køber, K Iversen

Department of Clinical Medicine

10 Citations (Scopus)

Abstract

Background: Hyponatraemia is a prognostic marker of increased mortality and morbidity in selected groups of hospitalised patients. The aim of the present study was to examine the prevalence and prognostic significance of hyponatraemia at hospital admission in an unselected population with a broad spectrum of medical and surgical diagnoses. Methods: Consecutive patients >40 years of age admitted to a general district hospital in Greater Copenhagen between 1 April 1998 and 31 March 1999. Median follow-up time was 5.16 years (range 0-4372 days). Plasma sodium measurements were available in 2960 patients, and hyponatraemia defined as P-Na⁺ <137mmol/L at hospital admission was present in 1105 (37.3 %) patients. Results: One-year mortality was higher for hyponatraemic patients than for normonatraemic patients: 27.5% versus 17.7%. Moreover, hyponatraemia was an independent predictor of short and long-term all-cause mortality after 1 year and after the entire observation period respectively: hazard ratio (HR) 1.6 (95 % confidence interval (CI) 1.4-1.9, P < 0.0001) and HR 1.4 (95 % CI 1.3-1.6, P < 0.0001). Patients with hyponatraemia had longer hospitalisations than patients with normonatraemia: 7.6 (±0.38) days vs 5.6 (±0.21) days, P < 0.001. There was no interaction between hyponatraemia at admission and any admission diagnoses (P > 0.05 for all interaction analyses). Conclusion: Hyponatraemia is associated with increased all-cause mortality and longer admission length independently of diagnosis and clinical variables.

Original language	English
Journal	Internal Medicine Journal (Print)
Volume	45
Issue number	2
Pages (from-to)	195-202
Number of pages	8
ISSN	1444-0903
DOIs	https://doi.org/10.1111/imj.12623
Publication status	Published - 1 Feb 2015

Keywords

Adult
Aged
Cohort Studies
Denmark
Female
Hospital Mortality
Hospitalization
Hospitals, Public
Humans
Hyponatremia
Kaplan-Meier Estimate
Male
Middle Aged
Patient Admission
Predictive Value of Tests
Reference Values
Risk Assessment
Severity of Illness Index
Survival Analysis
Urban Population

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10.1111/imj.12623

Cite this

@article{65e38521a9864364bd83353fa610a845,

title = "Hyponatraemia at hospital admission is a predictor of overall mortality",

abstract = "Background: Hyponatraemia is a prognostic marker of increased mortality and morbidity in selected groups of hospitalised patients. The aim of the present study was to examine the prevalence and prognostic significance of hyponatraemia at hospital admission in an unselected population with a broad spectrum of medical and surgical diagnoses. Methods: Consecutive patients >40 years of age admitted to a general district hospital in Greater Copenhagen between 1 April 1998 and 31 March 1999. Median follow-up time was 5.16 years (range 0-4372 days). Plasma sodium measurements were available in 2960 patients, and hyponatraemia defined as P-Na+ <137mmol/L at hospital admission was present in 1105 (37.3 %) patients. Results: One-year mortality was higher for hyponatraemic patients than for normonatraemic patients: 27.5% versus 17.7%. Moreover, hyponatraemia was an independent predictor of short and long-term all-cause mortality after 1 year and after the entire observation period respectively: hazard ratio (HR) 1.6 (95 % confidence interval (CI) 1.4-1.9, P < 0.0001) and HR 1.4 (95 % CI 1.3-1.6, P < 0.0001). Patients with hyponatraemia had longer hospitalisations than patients with normonatraemia: 7.6 (±0.38) days vs 5.6 (±0.21) days, P < 0.001. There was no interaction between hyponatraemia at admission and any admission diagnoses (P > 0.05 for all interaction analyses). Conclusion: Hyponatraemia is associated with increased all-cause mortality and longer admission length independently of diagnosis and clinical variables.",

keywords = "Adult, Aged, Cohort Studies, Denmark, Female, Hospital Mortality, Hospitalization, Hospitals, Public, Humans, Hyponatremia, Kaplan-Meier Estimate, Male, Middle Aged, Patient Admission, Predictive Value of Tests, Reference Values, Risk Assessment, Severity of Illness Index, Survival Analysis, Urban Population",

author = "L Balling and F Gustafsson and Goetze, {J P} and M Dalsgaard and H Nielsen and S Boesgaard and M Bay and V Kirk and Nielsen, {O W} and L K{\o}ber and K Iversen",

note = "{\textcopyright} 2014 Royal Australasian College of Physicians.",

year = "2015",

month = feb,

day = "1",

doi = "10.1111/imj.12623",

language = "English",

volume = "45",

pages = "195--202",

journal = "Internal Medicine Journal",

issn = "1444-0903",

publisher = "Wiley-Blackwell Publishing Asia",

number = "2",

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TY - JOUR

T1 - Hyponatraemia at hospital admission is a predictor of overall mortality

AU - Balling, L

AU - Gustafsson, F

AU - Goetze, J P

AU - Dalsgaard, M

AU - Nielsen, H

AU - Boesgaard, S

AU - Bay, M

AU - Kirk, V

AU - Nielsen, O W

AU - Køber, L

AU - Iversen, K

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Background: Hyponatraemia is a prognostic marker of increased mortality and morbidity in selected groups of hospitalised patients. The aim of the present study was to examine the prevalence and prognostic significance of hyponatraemia at hospital admission in an unselected population with a broad spectrum of medical and surgical diagnoses. Methods: Consecutive patients >40 years of age admitted to a general district hospital in Greater Copenhagen between 1 April 1998 and 31 March 1999. Median follow-up time was 5.16 years (range 0-4372 days). Plasma sodium measurements were available in 2960 patients, and hyponatraemia defined as P-Na+ <137mmol/L at hospital admission was present in 1105 (37.3 %) patients. Results: One-year mortality was higher for hyponatraemic patients than for normonatraemic patients: 27.5% versus 17.7%. Moreover, hyponatraemia was an independent predictor of short and long-term all-cause mortality after 1 year and after the entire observation period respectively: hazard ratio (HR) 1.6 (95 % confidence interval (CI) 1.4-1.9, P < 0.0001) and HR 1.4 (95 % CI 1.3-1.6, P < 0.0001). Patients with hyponatraemia had longer hospitalisations than patients with normonatraemia: 7.6 (±0.38) days vs 5.6 (±0.21) days, P < 0.001. There was no interaction between hyponatraemia at admission and any admission diagnoses (P > 0.05 for all interaction analyses). Conclusion: Hyponatraemia is associated with increased all-cause mortality and longer admission length independently of diagnosis and clinical variables.

AB - Background: Hyponatraemia is a prognostic marker of increased mortality and morbidity in selected groups of hospitalised patients. The aim of the present study was to examine the prevalence and prognostic significance of hyponatraemia at hospital admission in an unselected population with a broad spectrum of medical and surgical diagnoses. Methods: Consecutive patients >40 years of age admitted to a general district hospital in Greater Copenhagen between 1 April 1998 and 31 March 1999. Median follow-up time was 5.16 years (range 0-4372 days). Plasma sodium measurements were available in 2960 patients, and hyponatraemia defined as P-Na+ <137mmol/L at hospital admission was present in 1105 (37.3 %) patients. Results: One-year mortality was higher for hyponatraemic patients than for normonatraemic patients: 27.5% versus 17.7%. Moreover, hyponatraemia was an independent predictor of short and long-term all-cause mortality after 1 year and after the entire observation period respectively: hazard ratio (HR) 1.6 (95 % confidence interval (CI) 1.4-1.9, P < 0.0001) and HR 1.4 (95 % CI 1.3-1.6, P < 0.0001). Patients with hyponatraemia had longer hospitalisations than patients with normonatraemia: 7.6 (±0.38) days vs 5.6 (±0.21) days, P < 0.001. There was no interaction between hyponatraemia at admission and any admission diagnoses (P > 0.05 for all interaction analyses). Conclusion: Hyponatraemia is associated with increased all-cause mortality and longer admission length independently of diagnosis and clinical variables.

KW - Adult

KW - Aged

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Hospital Mortality

KW - Hospitalization

KW - Hospitals, Public

KW - Humans

KW - Hyponatremia

KW - Kaplan-Meier Estimate

KW - Male

KW - Middle Aged

KW - Patient Admission

KW - Predictive Value of Tests

KW - Reference Values

KW - Risk Assessment

KW - Severity of Illness Index

KW - Survival Analysis

KW - Urban Population

U2 - 10.1111/imj.12623

DO - 10.1111/imj.12623

M3 - Journal article

C2 - 25370908

SN - 1444-0903

VL - 45

SP - 195

EP - 202

JO - Internal Medicine Journal

JF - Internal Medicine Journal

IS - 2

ER -

Hyponatraemia at hospital admission is a predictor of overall mortality

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Keywords

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