Key result
Hyponatremia occurred in 4.1% of TAVR hospitalizations and was independently associated with a significantly higher risk of in-hospital mortality (adjusted OR 3.59).
Why the study?
Hyponatremia is linked to worse outcomes in cardiac patients, but its impact in patients undergoing TAVR remains unclear.
Does hyponatremia increase the risk of in-hospital mortality and disability in patients undergoing TAVR?
Does hyponatremia increase the risk of in-hospital mortality and disability in patients undergoing TAVR?
Hyponatremia is present in approximately 4% of TAVR hospitalizations and is independently associated with a more than 3-fold increased risk of in-hospital mortality, as well as greater disability, longer hospital stays, and higher costs.
Flags hyponatremia for closer monitoring in TAVR; extends observational risk data but leaves open whether correction is beneficial.
Background Hyponatremia is linked to worse outcomes in cardiac patients, but its impact in transcatheter aortic valve replacement (TAVR) remains unclear. We examined the prevalence, predictors, and outcomes of hyponatremia among TAVR patients using the National Inpatient Sample (NIS). Methods The NIS was queried to identify 369,190 hospitalizations for TAVR, stratified by hyponatremia status. Survey weighted logistic regressions estimated associations between hyponatremia and in-hospital mortality and disability as identified by discharge disposition. Predictors of hyponatremia were assessed using survey weighted multivariable logistic regression. Both were adjusted for demographics, comorbidities, and hospital characteristics. Results Hyponatremia was present in 4.1% (n=15,060) of TAVR admissions. Independent predictors of hyponatremia included higher Charlson comorbidity scores (OR 2.88, 2.29–3.61), female sex (OR 1.15, 1.06–1.25), and atrial fibrillation (OR 1.35, 1.25–1.46). Patients with hyponatremia had significantly higher crude mortality (3.9% vs 1.0%; p<0.001) and adjusted odds of in-hospital death (adjusted OR 3.59; 95% CI, 2.90–4.45). Disability was more common among hyponatremic patients (51.4% vs 23.2%; p<0.001). Hyponatremia was associated with longer length of stay (mean 9.9 vs 3.0 days; p<0.001) and higher total charges ($331,567 vs $216,911; p<0.001). Significant differences in comorbidity profiles were noted, with higher prevalence of end-stage renal disease (9.9% vs. 3.2%), malnutrition (5.4% vs. 1.1%), and atrial fibrillation (43.1% vs. 35.5%) among hyponatremic patients. Conclusions Hyponatremia occurs in approximately 4% of TAVR hospitalizations and is independently associated with substantially increased risk of in-hospital mortality, disability, longer hospital stays, and greater costs. Hyponatremia should be recognized as an important prognostic factor in patients undergoing TAVR to aid in risk stratification and management.
No takes yet. Share an insight, caveat, or question.
Cohen et al. (2026) studied this question. Hyponatremia occurred in 4.1% of TAVR hospitalizations and was independently associated with a significantly higher risk of in-hospital mortality (adjusted OR 3.59).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: