On-admission hyponatremia in patients hospitalized for acute heart failure was associated with an increased risk of all-cause mortality (HR 1.43; 95% CI 1.11-1.83).
Cohort (n=2,556)
No
Does on-admission hyponatremia and worsening sodium levels predict long-term mortality in patients hospitalized for acute heart failure?
On-admission hyponatremia and in-hospital drops in serum sodium are independent predictors of long-term all-cause and cardiovascular mortality in acute heart failure.
Hazard Ratio: 1.43 (95% CI 1.11–1.83)
BACKGROUND: Hyponatremia predicts poor prognosis in patients with acute heart failure (AHF). However, the association of the severity of hyponatremia and changes of serum sodium levels with long-term outcome has not been delineated. METHODS AND RESULTS: The study population was drawn from the HARVEST registry (Heart Failure Registry of Taipei Veterans General Hospital), so that patients hospitalized for acute heart failure (AHF) composed this study. The National Death Registry was linked to identify the clinical outcomes of all-cause mortality and cardiovascular death, with a follow-up duration of up to 4 years. Among a total of 2556 patients (76.4 years of age, 67% men), 360 had on-admission hyponatremia, defined as a serum sodium level of 3 mEq/L was associated with a marked increase of mortality than those with minimal or no drop of sodium levels. In addition, subjects with on-admission hyponatremia and drops of serum sodium levels during hospitalization had an incremental risk of death (2.26, 1.36-3.74), relative to those with normonatremia at admission and no treatment-related drop of serum sodium level in the fully adjusted model. CONCLUSIONS: On-admission hyponatremia is an independent predictor for long-term outcomes in patients hospitalized for AHF. Combined the on-admission hyponatremia with drops of serum sodium levels during hospitalization may make a better risk assessment in AHF patients.
Lu et al. (2016) conducted a cohort in Acute heart failure (n=2,556). On-admission hyponatremia (serum sodium <135 mEq/L) vs. Normonatremia was evaluated on All-cause mortality (HR 1.43, 95% CI 1.11-1.83). On-admission hyponatremia in patients hospitalized for acute heart failure was associated with an increased risk of all-cause mortality (HR 1.43; 95% CI 1.11-1.83).