Serum sodium correction rate and the outcome in severe hyponatremia

Am J Emerg Med. 2017 Nov;35(11):1691-1694. doi: 10.1016/j.ajem.2017.05.050. Epub 2017 May 31.

Abstract

Study objective: We investigated the serum sodium correction rate on length of hospitalization and survival rate, in severe chronic hyponatremic patients at the Emergency Department (ED).

Design: An observational study using clinical chart review.

Setting: The ED of the University Hospital of Marcianise, Caserta, Italy with approximately 30,000 patients visits a year.

Type of participants: We reviewed sixty-seven patients with severe hyponatremia subdivided in 2 subgroups: group A consisting of 35 patients with serum sodium correction rate<0.3mmol/h and group B consisting of 32 patients with serum sodium correction rate between <0.5 and ≥0.3mmol/h.

Intervention: Emergency patients were evaluated for serum sodium correction rate for hyponatremia by clinical chart review.

Measurements and main results: Severe hyponatremia was defined as a serum sodium level<120mmol/l. Mean serum sodium correction rate of hyponatremia was of 0.17±0.09% in group A and 0.41±0.05% in group B (p<0.001 vs group A). The length of hospital stay was 10.7±3.7days for group A, and it was significantly decreased to 3.8±0.4days for group B (p<0.005 vs group A). In addition we observed that correction rate of hyponatremia in group A was associated with a significantly lower survival rate (25%) in comparison to group B (60%) (p<0.001 vs group A).

Conclusion: We observed that serum sodium correction rate ≥0.3 and <0.5mmol/h was associated with a shorter length of hospital stay and a major survival rate.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Emergency Service, Hospital
  • Female
  • Fluid Therapy / methods*
  • Humans
  • Hyponatremia / mortality
  • Hyponatremia / therapy*
  • Italy
  • Length of Stay*
  • Male
  • Retrospective Studies
  • Saline Solution, Hypertonic / therapeutic use*
  • Survival Rate
  • Time Factors
  • Treatment Outcome

Substances

  • Saline Solution, Hypertonic