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July 29, 2016BMC CancerOpen Access

The occurrence of hyponatremia and its importance as a prognostic factor in a cross-section of cancer patients

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Key result

Euvolemic and hypervolemic hyponatremia was associated with a significantly increased risk of death (HR 2.7) in patients with breast, colorectal, lung cancer, or lymphoma.

Why the study?

Does the development of euvolemic or hypervolemic hyponatremia reduce overall survival in patients with cancer?

Population

1,758 adults with breast, colorectal, small cell lung, non-small cell lung cancer, or lymphoma, who had ≥1…

Comparison

Development of euvolemic or hypervolemic… vs No development of hyponatremia during follow-up

Design

Cohort

Follow-up

mean 3.1 years

Authors

JCJorge J. CastilloHarvard UniversityIGIlya GlezermanMemorial Sloan Kettering Cancer CenterSBSusan BoklageHealth Outcomes Solutions (United States)

Discussion

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Implication

Hyponatremia may flag higher mortality in these cancers; leaves open whether correction improves survival.

Study Design

Type

Cohort (n=1,758)

Multicenter

Yes

Structured PICO

Does the development of euvolemic or hypervolemic hyponatremia reduce overall survival in patients with cancer?

P
Population
1,758 adult patients with lymphoma, breast, colorectal, or lung cancer who received radiation or chemotherapy within 6 months of diagnosis, followed for a mean of 3.1 years.
E
Exposure
Development of euvolemic or hypervolemic hyponatremia (analyzed as a time-varying covariate)
C
Comparator
No development of hyponatremia during follow-up
O
Outcome
Overall survival (OS)hard clinical

Main Result

Hazard Ratio: 2.7 (95% CI 2.2–3.4)

p-value: p=<0.01

Euvolemic and hypervolemic hyponatremia are common across multiple cancer types and are independently associated with significantly reduced overall survival.

Limitations

  • Retrospective design
  • Geographically constrained to two delivery networks, which may limit generalizability
  • Excluded Medicaid and uninsured patients in one of the networks
  • Classification of hyponatremia type used an unvalidated multi-stage algorithm
  • Potential erroneous exclusion of patients with hypovolemic hyponatremia
  • Not a random sample
  • Geographically constrained areas
  • Exclusion of Medicaid/uninsured in one network
  • Potential incomplete data capture for out-of-network care
  • Classification of hyponatremia type assigned using an unvalidated multi-stage algorithm

Cite This Study

Castillo et al. (2016) conducted a cohort in Cancer (lymphoma, breast, colorectal, lung) (n=1,758). Euvolemic and hypervolemic hyponatremia vs. No hyponatremia was evaluated on Overall survival (HR 2.7, 95% CI 2.2-3.4, p=<0.01). Euvolemic and hypervolemic hyponatremia was associated with a significantly increased risk of death (HR 2.7) in patients with breast, colorectal, lung cancer, or lymphoma.

synapsesocial.com/papers/6a790d2770e13102dc6740bahttps://doi.org/10.1186/s12885-016-2610-9
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Also Consider

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  3. 3The Incidence of Hyponatraemia and Its Effect on the ECOG Performance Status among Lung Cancer Patients2013 · 31 citations
  4. 4Hyponatremia Improvement Is Associated with a Reduced Risk of Mortality: Evidence from a Meta-Analysis2015 · 140 citations
  5. 5Oncologic emergencies: Pathophysiology, presentation, diagnosis, and treatment2011 · 145 citations