Severe hyponatremia in patients hospitalized for heart failure was associated with increased risk-adjusted mortality compared to normonatremia (OR 1.78; 95% CI 1.59-1.99; P<.0001).
Observational (n=115,969)
Are sodium abnormalities (hyponatremia and hypernatremia) associated with increased hospital mortality, length of stay, and costs in patients hospitalized for congestive heart failure?
Both hyponatremia and hypernatremia are associated with significantly increased hospital mortality, length of stay, and costs in patients hospitalized for heart failure compared to normonatremia.
Odds Ratio: 1.78 (95% CI 1.59–1.99)
p-value: p=<.0001
Hyponatremia presumably is associated with adverse clinical outcomes in patients with congestive heart failure (CHF), but risk thresholds and economic burden are less studied. The authors analyzed 115, 969 patients hospitalized for CHF and grouped them by serum sodium levels (severe hyponatremia, ≤130 mEq/L; hyponatremia, 131-135 mEq/L; normonatremia, 136-145 mEq/L; hypernatremia, >145 mEq/L). Univariable and multivariable analyses on the associated clinical and economic outcomes were performed. The most common abnormality was hyponatremia (15. 9%), followed by severe hyponatremia (5. 3%) and hypernatremia (3. 2%). Hospital mortality was highest for severe hyponatremia (7. 6%), followed by hypernatremia (6. 7%) and hyponatremia (4. 9%) (P<. 0001). Compared with normonatremia, risk-adjusted mortality was highest for severe hyponatremia (odds ratio OR, 1. 78; 95% confidence interval CI, 1. 59-1. 99), followed by hypernatremia (OR, 1. 55; 95% CI, 1. 34-1. 80) and hyponatremia (OR, 1. 29; 95% CI, 1. 19-1. 40; all P<. 0001). Risk-adjusted hospital prolongation was greater for each level of sodium abnormality than for normonatremia, ranging from 0. 42 (CI, 0. 26-0. 60) days for hypernatremia to 1. 28 (CI, 1. 11-1. 47) days for severe hyponatremia. Risk-adjusted attributable hospital cost increase was highest for severe hyponatremia (1132; CI, 856-1425; all (P<. 0001). Sodium abnormalities were common in patients hospitalized for CHF. Adverse outcomes resulted not only from severe hyponatremia, but also from mild hyponatremia and hypernatremia.
Shorr et al. (Sat,) conducted a observational in Congestive heart failure (n=115,969). Severe hyponatremia (≤130 mEq/L) vs. Normonatremia (136-145 mEq/L) was evaluated on Risk-adjusted mortality (OR 1.78, 95% CI 1.59-1.99, p=<.0001). Severe hyponatremia in patients hospitalized for heart failure was associated with increased risk-adjusted mortality compared to normonatremia (OR 1.78; 95% CI 1.59-1.99; P<.0001).