Characteristics, Symptoms, and Outcome of Severe Dysnatremias Present on Hospital Admission

Arampatzis, Spyridon; Frauchiger, Bettina Sarah; Fiedler, Georg Martin; Leichtle, Alexander Benedikt; Buhl, Daniela; Schwarz, Christoph; Funk, Georg‐Christian; Zimmermann, Heinz; Exadaktylos, Aristomenis K.; Lindner, Gregor

doi:10.1016/j.amjmed.2012.04.041

Cited by 108 publications

(101 citation statements)

References 23 publications

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“…Diagnostic adequacy of predictors that was found in two regression models was evaluated by receiver operating characteristic (ROC) curve analysis and specificity, sensitivity, negative predictive value (NPV), positive predictive value (PPV), test accuracy, Youden index, and area under curve (AUC) [13] values were compared. Cut off value was calculated by Youden index method.…”

Section: Discussionmentioning

confidence: 99%

What is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?

Ateş

Bozkurt

et al. 2016

Blood Coagulation &Amp; Fibrinolysis

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Because of similar clinical manifestations and laboratory findings, differential diagnosis of pulmonary embolism and community-acquired pneumonia (CAP) is generally difficult. Therefore, this study was conducted to find good markers for the easy, cheap, and fast differential diagnosis of pulmonary embolism and CAP. Thirty-four patients diagnosed with pulmonary embolism and 38 patients with CAP who were admitted to either emergency department or chest diseases outpatient clinic were included in this study. On admission and third day, complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate, procalcitonin (PCT), and D-dimer levels of each patient were measured. Neutrophil-to-lymphocyte ratio (NLR) was calculated using the formula NLR = neutrophil count/lymphocyte count. NLR/D-dimer and PCT/D-dimer ratios were also calculated. First day neutrophil count (P = 0.005), NLR (P = 0.002), CRP (P < 0.001), erythrocyte sedimentation rate (P < 0.001), PCT (P < 0.001), NLR/D-dimer (P < 0.001), and PCT/D-dimer (P < 0.001) levels were higher in patients with CAP compared with patients with pulmonary embolism. In stepwise logistic regression analysis done with all the parameters used for the differential diagnosis of pulmonary embolism and CAP, CRP, PCT/D-dimer, and NLR/D-dimer were found to be independent predictive factors for the presence of CAP. Among these factors, NLR/D-dimer ratio was found to be the most sensitive (97.4%) to have the highest negative predictive value 96.7% and to be the most accurate (area under curve = 0.921) (91.7%) parameter for the differential diagnosis of pulmonary embolism and CAP. In this study, NLR/D-dimer ratio was found to be more sensitive and more selective with negative predictive value and area under curve for the differential diagnosis of pulmonary embolism and CAP compared with other laboratory tests.

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Section: Discussionmentioning

confidence: 99%

What is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?

Ateş

Bozkurt

et al. 2016

Blood Coagulation &Amp; Fibrinolysis

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“…Therefore, CVVH treatment might be more effective than conventional treatment for the management of acute severe hypernatremia in critically ill patients (21). However, some studies reported lower mortality rates (24% -57.8%) in patients with severe hypernatremia (2,12,18,26) because their studies defined severe hypernatremia as a serum sodium level < 160 mEq/L and did not distinguish between acute hypernatremia and chronic hypernatremia.…”

Section: Discussionmentioning

confidence: 99%

The Reduction Rate of Serum Sodium and Mortality in Patients Undergoing Continuous Venovenous Hemofiltration for Acute Severe Hypernatremia

Liu

Bai

et al. 2016

The American Journal of the Medical Sciences

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“…Hypernatremia, defined as a [Na] S exceeding 145 mmol/L, has an estimated prevalence of 2% among patients admitted to hospitals and is less common than hyponatremia, which is seen in about 10% of this population[23]. …”

Section: Hypernatremiamentioning

confidence: 99%

Hypertonicity: Clinical entities, manifestations and treatment

Rondon‐Berrios

Argyropoulos

Ing

et al. 2017

WJN

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Hypertonicity causes severe clinical manifestations and is associated with mortality and severe short-term and long-term neurological sequelae. The main clinical syndromes of hypertonicity are hypernatremia and hyperglycemia. Hypernatremia results from relative excess of body sodium over body water. Loss of water in excess of intake, gain of sodium salts in excess of losses or a combination of the two are the main mechanisms of hypernatremia. Hypernatremia can be hypervolemic, euvolemic or hypovolemic. The management of hypernatremia addresses both a quantitative replacement of water and, if present, sodium deficit, and correction of the underlying pathophysiologic process that led to hypernatremia. Hypertonicity in hyperglycemia has two components, solute gain secondary to glucose accumulation in the extracellular compartment and water loss through hyperglycemic osmotic diuresis in excess of the losses of sodium and potassium. Differentiating between these two components of hypertonicity has major therapeutic implications because the first component will be reversed simply by normalization of serum glucose concentration while the second component will require hypotonic fluid replacement. An estimate of the magnitude of the relative water deficit secondary to osmotic diuresis is obtained by the corrected sodium concentration, which represents a calculated value of the serum sodium concentration that would result from reduction of the serum glucose concentration to a normal level.

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Characteristics, Symptoms, and Outcome of Severe Dysnatremias Present on Hospital Admission

Cited by 108 publications

References 23 publications

What is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?

What is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?

The Reduction Rate of Serum Sodium and Mortality in Patients Undergoing Continuous Venovenous Hemofiltration for Acute Severe Hypernatremia

Hypertonicity: Clinical entities, manifestations and treatment

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