Association Between Small Decrease in Serum Sodium Concentration within the Normal Range and All‐Cause and Cardiovascular Mortality in Elderly Adults over 5 Years

Ahn, Shin Young; Park, Yoon Soo; Lee, Seong W.; Baek, Seon Ha; Kim, Sejoong; Na, Ki Young; Kim, Ki Woong; Chae, Dong‐Wan; Chin, Ho Jun

doi:10.1111/jgs.13937

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…Because of the diluting effect of hyperglycemia on sodium concentration, the true value of s-sodium in hyperglycemic patients is glucose-corrected sodium [28]. One previous study demonstrated the superiority of glucose-corrected serum-sodium to predict mortality over measured serum-sodium, and the authors suggested that glucose-corrected serum-sodium should be considered in studies analyzing serum-sodium [31]. To our knowledge our study is the first study to report serum-sodium and glucose-corrected serum-sodium in an unselected hospital population.…”

Section: Discussionmentioning

confidence: 99%

Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study

et al. 2019

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Background Although electrolyte imbalances (EIs) are common in the emergency department (ED), few studies have examined the occurrence of such conditions in an unselected population. Objectives To investigate the frequency of EI among adult patients who present to the ED, with regards to type and severity, and the association with age and sex of the patient, hospital length of stay (LOS), readmission, and mortality. Methods A retrospective cohort study. All patients ≥ 18 years referred for any reason to the ED between January 1, 2010, and December 31, 2015, who had measured blood electrolytes were included. In total, 62 991 visits involving 31 966 patients were registered. Results EIs were mostly mild, and the most common EI was hyponatremia (glucose-corrected) (24.6%). Patients with increasing severity of EI had longer LOS compared with patients with normal electrolyte measurements. Among all admitted patients, there were 12928 (20.5%) readmissions within 30 days from discharge during the study period. Hyponatremia (glucose-corrected) was associated with readmission, with an adjusted odds ratio (OR) of 1.25 (95% CI, 1.18–1.32). Hypomagnesemia and hypocalcemia (albumin-corrected) were also associated with readmission, with ORs of 1.25 (95% CI, 1.07–1.45) and 1.22 (95% CI, 1.02–1.46), respectively. Dysnatremia, dyskalemia, hypercalcemia, hypermagnesemia, and hyperphosphatemia were associated with increased in-hospital mortality, whereas all EIs except hypophosphatemia were associated with increased 30-day and 1-year mortality. Conclusions EIs were common and increasing severity of EIs was associated with longer LOS and increased in-hospital, 30-days and 1-year mortality. EI monitoring is crucial for newly admitted patients, and up-to-date training in EI diagnosis and treatment is essential for ED physicians.

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Section: Discussionmentioning

confidence: 99%

Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study

et al. 2019

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“…Sodium is widely accepted as a risk factor that increases blood pressure 11,42 . However, in recent studies, serum sodium was also found to be inversely associated with cardiovascular risk and mortality 12–14 . Sodium may have pleiotropic effects on the cardiovascular system and glucose metabolism 43 .…”

Section: Discussionmentioning

confidence: 99%

“…Dietary sodium is associated with serum sodium, 10 and serum sodium is also known as a factor that could increase the risk of hypertension 11 . However, some studies found that lower serum sodium, even within the normal range, is associated with poor prognosis 12–14 . Meanwhile, hyponatremia is independently associated with an increased risk of diabetes 15 .…”

Section: Introductionmentioning

confidence: 99%

“…11 However, some studies found that lower serum sodium, even within the normal range, is associated with poor prognosis. 12 , 13 , 14 Meanwhile, hyponatremia is independently associated with an increased risk of diabetes. 15 Sodium and glucose are the main contributors that activate neurohumoral regulation, maintaining a stable range of osmolality.…”

Section: Introductionmentioning

confidence: 99%

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Serum sodium level is inversely associated with new‐onset diabetes in hypertensive patients

Cheng

Liu

Cai

et al. 2022

Journal of Diabetes

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Background: Serum sodium level is associated with cardiovascular and endocrine health. Though decreased serum sodium is considered to be associated with reduced hypertension risk, some studies also found that it may increase the risk of diabetes. This study aimed to investigate the association of serum sodium with new-onset diabetes in hypertensive patients.Methods: Based on the annual health examinations from 2011 to 2016 in Dongguan City, Guangdong, China, hypertensive patients without diabetes at baseline were selected. Logistic regression and restricted cubic spline were used to evaluate the association between serum sodium level and new-onset diabetes. Subgroup analysis was also conducted.Results: A total of 4438 hypertensive patients with a mean age of 58.65 years were included, of whom 48.9% were male. During a median follow-up of 35.1 months, 617 (13.9%) of the subjects developed new-onset diabetes. Per 1-SD (3.39 mmol/L) increment of serum sodium was associated with a 14% lower risk of new-onset diabetes (odds ratio = 0.86; 95% CI: 0.78, 0.97; p = 0.01). The lowest quartile of serum sodium was associated with the lowest diabetes risk. The restricted cubic spline showed a linear inverse relationship (nonlinear p = 0.72). Across all the subgroups, the inverse association was consistent (p for interaction >0.05). Conclusion: An inverse association of serum sodium with new-onset diabetes in hypertensive patients was observed.

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“…13 One previous study demonstrated the superiority of glucose-corrected serum-sodium to predict mortality over measured serum-sodium, and the authors suggested that glucose-corrected serum-sodium should be considered in studies analyzing serum-sodium. 16 It is well known that dysnatremia is associated with longer hospital stay. According to a recent meta-analysis by Corona et al, investigating 46 studies, mean hospital stay was 3 days longer in hyponatremic patients.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of electrolyte imbalance among elderly patients and its relationship to the outcome and duration of stay in emergency

Chander¹

2022

Int J Clin Trials

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Background: Electrolyte imbalance (EI) is a measurable biochemical parameter that determines the clinical manifestations of interactions between various metabolic events like: hydration deficiencies, hormones deficiencies, vascular events, sepsis, etc. The aim of the study was to investigate the frequency of EI among elderly patients who present to the emergency department (ED), with regards to type and severity, and the association with age and sex of the patient, hospital stay, readmission, and mortality.Method: A hospital based prospective observational study was conducted on randomly selected 190 patients with EI, attending medicine OPD of sub-district hospital Bishnah, district Jammu, J and K, for a period of 6 months. Results: The median age of all patients was 69 years, with 43.68% patients were females. EIs were mostly mild, the most common EI was hyponatremia (14.74%). The 65 patients suffered from an either kind of severe EI. The 116 (61.05%) patients had no EI, 59 patients had one EI and 15 patients had two or more than two EIs. Median stay for patients with normal to mild/moderate to severe hyponatremia and hypernatremia was 3 and 5 days and 3 and 7 days respectively. Among all admitted patients, there were 20.5% (39) readmissions within 30 days from discharge during the study period.Conclusions: Increasing severity of EI was associated with longer hospital stay. Health-care personnel should be effectively trained in the diagnosis and management of EIs.

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Association Between Small Decrease in Serum Sodium Concentration within the Normal Range and All‐Cause and Cardiovascular Mortality in Elderly Adults over 5 Years

Abstract: A slightly lower serum sodium concentration within the normal range was a major risk factor for mortality in elderly adults. Sodium level corrected according to serum glucose concentration was a more meaningful risk factor than measured sodium level.

Cited by 4 publications

References 28 publications

Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study

Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study

Serum sodium level is inversely associated with new‐onset diabetes in hypertensive patients

A retrospective study of electrolyte imbalance among elderly patients and its relationship to the outcome and duration of stay in emergency

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