Key result
Severe hypernatremia was associated with a 5.79-fold increased odds of ICU mortality compared to normonatremia among critically ill adult patients.
Why the study?
Hypernatremia in critical care is a major cause of morbidity and mortality, but data had not been evaluated in South African hospitals.
Does hypernatremia increase ICU mortality and length of stay in critically ill adult patients?
Cohort (n=833)
No
Does hypernatremia increase ICU mortality and length of stay in critically ill adult patients?
Odds Ratio: 5.79 (95% CI 2.78–12.06)
Absolute Event Rate: 56.25% vs 18.16%
p-value: p=<0.001
Hypernatremia is highly prevalent in South African ICU patients and is associated with significantly increased morbidity, length of stay, and mortality.
Background Hypernatremia in the critical care setting is a major cause of morbidity and mortality. However, data pertaining to this has not been evaluated in South African hospitals. The aim of this study was to evaluate hypernatremia with regards to its prevalence, associated factors, and outcomes at an academic hospital intensive care unit (ICU) in Johannesburg, South Africa. Methods The ICU charts of patients admitted to the Charlotte Maxeke Johannesburg Academic Hospital adult general ICU from June 1, 2016 to May 31, 2017 were retrospectively reviewed. Subjects were categorized into three groups namely, ICU-acquired hypernatremia (IAH), pre-admission hypernatremia (PAH), and normonatremia. Data was compared between the three groups. Results Of the 833 subjects that were enrolled, 310 (37.2%) were hypernatremic. IAH was present in 144 (17.2%) and PAH in 166 (19.9%) subjects. Hypernatremia was significantly (p <0.05) associated with a higher rate of altered mental status, higher Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) scores, a higher rate and duration of mechanical ventilation, a greater need for inotropic/vasopressor support, longer ICU stay and higher ICU mortality. Conclusion Hypernatremia in ICU patients remains a significant contributor to morbidity, mortality, and ICU length of stay. The prevalence of hypernatremia was much higher than that reported in higher-income countries.
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Mapata et al. (2022) conducted a cohort in Intensive care unit admission (n=833). Severe hypernatremia vs. Normonatremia was evaluated on ICU mortality (OR 5.79, 95% CI 2.78-12.06, p=<0.001). Severe hypernatremia was associated with a 5.79-fold increased odds of ICU mortality compared to normonatremia among critically ill adult patients.
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