Affiliation:
1. Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
2. Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, Illinois
3. Medicine Service, Division of Nephrology, Raymond G. Murphy VA Medical Center, Albuquerque, New Mexico
Abstract
Background
Hospital-acquired hypernatremia is highly prevalent, overlooked, and associated with unfavorable consequences. There are limited studies examining the outcomes and discharge dispositions of various levels of hospital-acquired hypernatremia in patients with or without CKD.
Methods
We conducted an observational retrospective cohort study, and we analyzed the data of 1,728,141 patients extracted from the Cerner Health Facts database (January 1, 2000, to June 30, 2018). In this report, we investigated the association between hospital-acquired hypernatremia (serum sodium [Na] levels >145 mEq/L) and in-hospital mortality or discharge dispositions with kidney function status at admission using adjusted multinomial regression models.
Results
Of all hospitalized patients, 6% developed hypernatremia after hospital admission. The incidence of in-hospital mortality was 12% and 1% in patients with hypernatremia and normonatremia, respectively. The risk of all outcomes was significantly greater for serum Na >145 mEq/L compared with the reference interval (serum Na, 135–145 mEq/L). In patients with hypernatremia, odds ratios (95% confidence interval) for in-hospital mortality, discharge to hospice, and discharge to nursing facilities were 14.04 (13.71 to 14.38), 4.35 (4.14 to 4.57), and 3.88 (3.82 to 3.94), respectively (P < 0.001, for all). Patients with eGFR (Chronic Kidney Disease Epidemiology Collaboration) 60–89 ml/min per 1.73 m2 and normonatremia had the lowest odds ratio for in-hospital mortality (1.60 [1.52 to 1.70]).
Conclusions
Hospital-acquired hypernatremia is associated with in-hospital mortality and discharge to hospice or to nursing facilities in all stages of CKD.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Transplantation,Nephrology,Critical Care and Intensive Care Medicine,Epidemiology
Cited by
1 articles.
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1. Incident Hypernatremia in Hospitalized Patients;Clinical Journal of the American Society of Nephrology;2023-10-02