Acquired hypernatraemia is an independent predictor of mortality in critically ill patients

S. D. O'Donoghue, J. M. Dulhunty, H. K. Bandeshe, S. Senthuran and J. R. Gowardman (2009) Acquired hypernatraemia is an independent predictor of mortality in critically ill patients. Anaesthesia, 64 5: 514-520.


Author S. D. O'Donoghue
J. M. Dulhunty
H. K. Bandeshe
S. Senthuran
J. R. Gowardman
Title Acquired hypernatraemia is an independent predictor of mortality in critically ill patients
Formatted title Acquired hypernatraemia is an independent predictor of mortality in critically ill patients
Journal name Anaesthesia   Check publisher's open access policy
ISSN 0003-2409
Publication date 2009-04-07
Year available 2009
Sub-type Article (original research)
DOI 10.1111/j.1365-2044.2008.05857.x
Volume 64
Issue 5
Start page 514
End page 520
Total pages 7
Editor Dr. D Bogod
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd.
Collection year 2010
Language eng
Subject C1
Abstract This study reports the incidence and associated mortality of acquired hypernatraemia (Na > 150 mmol.l−1) in a general medical/surgical intensive care unit. Patients admitted over a 5-year period with normal sodium values were eligible for inclusion; exclusions were made for burn/neurosurgical diagnoses and for hypertonic saline therapy. From 3475 admissions (3317 patients), 266 (7.7%) episodes of hypernatraemia were observed. Hospital mortality was 33.5% in the hypernatraemic group and 7.7% in the normonatraemic group (p < 0.001). Acquired hypernatraemia was an independent risk factor for in-hospital mortality (OR 1.97, 95% CI 1.37–2.82, p < 0.001). Intermediate sodium levels (145–150 mmol.l−1) were associated with increased mortality (OR 1.42, 95% CI 1.02–1.98). Uncorrected sodium at discharge (p = 0.001) and peak sodium (p = 0.001) were better predictors of mortality than time to onset (p = 0.71) and duration of hypernatraemia (p = 1.0). Hypernatraemia avoidance is justified, but determinants of hypernatraemia and benefits of targeted treatment strategies require further elucidation.
Formatted abstract This study reports the incidence and associated mortality of acquired hypernatraemia (Na > 150 mmol.l−1) in a general medical/surgical intensive care unit. Patients admitted over a 5-year period with normal sodium values were eligible for inclusion; exclusions were made for burn/neurosurgical diagnoses and for hypertonic saline therapy. From 3475 admissions (3317 patients), 266 (7.7%) episodes of hypernatraemia were observed. Hospital mortality was 33.5% in the hypernatraemic group and 7.7% in the normonatraemic group (p < 0.001). Acquired hypernatraemia was an independent risk factor for in-hospital mortality (OR 1.97, 95% CI 1.37–2.82, p < 0.001). Intermediate sodium levels (145–150 mmol.l−1) were associated with increased mortality (OR 1.42, 95% CI 1.02–1.98). Uncorrected sodium at discharge (p = 0.001) and peak sodium (p = 0.001) were better predictors of mortality than time to onset (p = 0.71) and duration of hypernatraemia (p = 1.0). Hypernatraemia avoidance is justified, but determinants of hypernatraemia and benefits of targeted treatment strategies require further elucidation.

Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Tue, 20 Apr 2010, 18:38:03 EST by Amanda Jones on behalf of Anaesthesiology and Critical Care - RBWH