Economic Impact of Hyponatremia in Hospitalized Patients: A Retrospective Cohort Study

Callahan, Mark; Hương, Trần Thu; Caplan, David; Yoon-Flannery, Kahyun

doi:10.3810/pgm.2009.03.1991

Cited by 74 publications

(70 citation statements)

References 30 publications

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“…The results of this study are consistent with others in showing that HN patients use healthcare services more extensively, and represent a patient population which is more expensive to treat in the inpatient setting. 5,22 Additionally, this study yields new findings in that patients in the real-world with hyponatremia resulting from various etiologies are more likely to be readmitted to the hospital than patients with similar demographics and characteristics who do not have hyponatremia. The results of the subgroup analysis were generally consistent with the results for the overall matched population, as the incremental burden estimates were directionally consistent.…”

Section: Discussionmentioning

confidence: 79%

“…Zilberberg et al and Callahan et al additionally reported that HN patients had a significantly greater need for ICU (4%-10%). 5,22 In the present study, LOS in the ICU and associated costs were also compared among HN and non-HN cohorts and, after adjustment for key patient characteristics, hyponatremia was associated with an incremental increase of 10.2% for ICU LOS and an 8.9% increase in ICU cost.…”

Section: Discussionmentioning

confidence: 90%

“…23 Callahan et al reported a $1200 increase in costs per admission for patients with mildto-moderate hyponatremia, and a $3540 increase for patients with moderate-to-severe hyponatremia, in comparison to non-HN patients. 22 The Institute for Healthcare Improvement reports that hospitalizations account for nearly one-third of the $882 billion spent on healthcare in the US in 2011, and that a substantial fraction of all hospitalizations are readmissions. 13,24 A recent meta-analysis of 30-day hospital readmission rates found 23.1% were classified as avoidable.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US

Amin

Deitelzweig

Christian

et al. 2012

Journal of Hospital Medicine

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BACKGROUND:Hyponatremia is a prevalent electrolyte disorder in hospitalized patients indicative of greater morbidity and mortality. A large‐scale retrospective analysis was conducted to evaluate the incremental burden of hospitalized hyponatremic (HN) versus non‐HN patients in terms of hospital resource utilization, costs, and hospital readmissions in the real‐world setting.METHODS:HN patients (≥18 years) were selected from the Premier Hospital Database between January 1, 2007 and March 31, 2010 and matched to a non‐HN control cohort using propensity score matching. Bivariate and multivariate statistics were employed to evaluate the differences in healthcare resource utilization, costs, and hospital readmissions between patient cohorts.RESULTS:Among the matched patient cohorts, length of stay (LOS) (8.8 ± 10.3 vs 7.7 ± 8.5 days, P < 0.001), hospital admission costs ($15,281 ± $24,054 vs $13,439 ± $22,198, P < 0.001), intensive care unit (ICU) LOS (5.5 ± 7.9 vs 4.9 ± 7.1 days, P < 0.001), and ICU costs ($8525 ± $13,342 vs $7597 ± $12,695, P < 0.001) were greater for the HN versus non‐HN cohort, as were hospital readmission rates 30 days postdischarge. Multivariate regressions further demonstrated that hyponatremia was associated with an increase of 10.9% for LOS, 8.2% for total hospitalization costs, 10.2% for ICU LOS, and 8.9% for ICU costs. Additionally, after multivariate adjustment, hyponatremia was associated with a 15.0% increased chance for hospital readmission 30 days postdischarge (P < 0.0001).CONCLUSIONS:Hyponatremia is an independent predictor of increased hospitalization LOS and cost, ICU admission and cost, and 30‐day hospital readmission, and therefore represents a potential target for intervention to reduce healthcare expenditures for a large population of hospitalized hyponatremic patients. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US

Amin

Deitelzweig

Christian

et al. 2012

Journal of Hospital Medicine

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“…Callahan et al, [8], found that admissions with hyponatremia had significantly longer hospital length of stay than those admitted without hyponatremia. In our study the effect of hyponatremia on differences in mean time to improve has been ruled out as the serum sodium was comparable in both the groups.…”

Section: References Discussionmentioning

confidence: 99%

Fractional Excretion of Sodium and Its Association with Prognosis of Decompensated Heart Failure Patients

Kumar

Bagarhatta

2015

JCDR

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“…These adverse outcomes were more frequent even when serum [Na + ] was in the range of 130-134 mmol/L. 3,5,16 Furthermore, worsening of hyponatremia during hospitalization is associated with increased adjusted odds of in-hospital mortality 17 and discharge to short-or long-term care facilities. 5 …”

Section: Prognostic Implicationsmentioning

confidence: 99%

Design of a prospective, multinational registry to evaluate patients hospitalized with hyponatremia: the HN Registry

Hauptman¹,

Greenberg²,

Verbalis³

et al. 2013

OAJCT

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Background: Hyponatremia is a prevalent condition in patients hospitalized across a broad range of conditions, including heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Whether present on admission or developing during hospitalization, hyponatremia has been associated with increased mortality, longer hospital stays, and higher costs. Little is known, however, about its management and outcomes outside of clinical trial settings. Methods: The Hyponatremia Registry (HN Registry) is a prospective, observational, multicenter, multinational study of patients hospitalized with either hypervolemic hyponatremia (cirrhosis and heart failure) in the United States or euvolemic hyponatremia (SIADH) in both the United States and Europe. Study enrollment began in September 2010 at community, tertiary, and academic medical centers. Overall, the HN Registry is expected to enroll .5,000 patients with hyponatremia, at .280 sites. Data will be used to characterize demographic and clinical characteristics of patients hospitalized with hyponatremia, evaluate the comparative effectiveness of available treatment modalities, and document and compare length of hospital stay as a reflection of resource use associated with hospital management. Discussion: Despite better understanding of the clinical consequences, economic impact, and prognostic significance of euvolemic and hypervolemic hyponatremia, there remains a need to evaluate current "real-world" management. The HN Registry is designed to provide contemporary data on in-hospital evaluation, management, and length of stay in a large cohort of adult patients with hyponatremia. The HN Registry generated several design and analytical challenges that required unique approaches to facilitate collection of the most clinically relevant data.

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Economic Impact of Hyponatremia in Hospitalized Patients: A Retrospective Cohort Study

Abstract: Hyponatremia at admission was associated with increased LOS and cost of care for hospitalized patients. Interventions or pharmacotherapies for the prompt treatment of hyponatremia could potentially reduce morbidity and LOS, thereby reducing the utilization of health care resources.

Cited by 74 publications

References 30 publications

Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US

Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US

Fractional Excretion of Sodium and Its Association with Prognosis of Decompensated Heart Failure Patients

Design of a prospective, multinational registry to evaluate patients hospitalized with hyponatremia: the HN Registry

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