Hospital-acquired Hyponatremia: Risk Factors and Outcomes

Correspondence (İletişim): Zeynep Ece Demirbaş, M.D. Dr. Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi, Ic Hastaliklari Klinigi, Tibbiye Cad. No: 13 Selimiye, Uskudar 34668, İstanbul, Turkey Phone (Telefon): +90 216 542 44 44 E-mail (E-posta): zeynepece@gmail.com Submitted Date (Başvuru Tarihi): 29.07.2018 Accepted Date (Kabul Tarihi): 31.07.2018 Copyright 2019 Haydarpaşa Numune Medical Journal OPEN ACCESS This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/). 380 Demirbaş et al., Hospital-acquired Hyponatremia: Risk Factors and Outcomes / doi: 10.14744/hnhj.2018.94899 been performed on the search for factors contributing to hospital-acquired hyponatremia in the general patient population. This study aims to investigate the demographic and clinical characteristics of the patients with hospital-acquired hyponatremia and to determine the relationship between hyponatremia and related mortality after the treatment they received before the development of hyponatremia. Materials and Methods This study was conducted retrospectively on 133 patients who developed hyponatremia during patient treatment in inpatient wards of our hospital between 2012 and 2013 for any reason. The data of adult patients who met the inclusion criteria were obtained from the hospital registry system. Exclusion criteria were as follows: the presence of hyponatremia at the time of hospitalization, failure to control sodium levels after the development of hyponatremia, pseudohyponatremia and being younger than 18 years. Information of the patients, including age (year), sex, duration of hospital stay in days, Na value (mEq/L) measured at admission, the final Na (mEq/L) measurement during hospitalization, the presence of comorbid diseases (hypertension, diabetes mellitus, malignancy, chronic renal failure, congestive heart failure, coronary artery disease, previous SVO, dementia, hypothyroidism, nephrotic syndrome, COPD, cirrhosis), which might contribute directly or indirectly to hyponatremia, the presence or absence of symptoms developed due to hyponatremia (nausea, vomiting. confusion, coma) and whether hospitalizations ended with mortality were recorded. As evaluation parameters, the hyponatremia threshold was considered to be less than 135 mEq/L, and the patients were divided into three groups in light of the recommendations of the most current guideline described by “Hyponatraemia Guideline Development Group (HGDG)” at the beginning of 2014 as mild (130-135 mEq/L), moderate (125-129 mEq/L) in light of and severe (<125 mEq/L) hyponatremia. The improvement was determined as the final measured sodium value exceeding 135 mEq/L. SPSS 22.0 (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. In addition to descriptive statistical methods (median, range), Mann-Whitney U test was used for the comparison of two independent groups, and Kruskal Wallis Test was employed for comparisons between more than two independent groups. The Pearson Chi-Square Test, Yates Continuity Correction Test, or Fisher's Full Probability Tests were used to compare qualitative data between groups. Shapiro-Wilk test was used to evaluate the fitness of continuous variables to a normal distribution, and Pearson Correlation Analysis was employed to assess correlations between parametric variables and Spearman Correlation Analysis for nonparametric variables. The results were expressed within a 95% confidence interval and p<0.05 level of significance.