Hypernatremia at admission predicts poor survival in patients with terminal cancer: a retrospective cohort study

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background Although palliative care providers, patients, and their familes rely heavily on accurate prognostication, the prognostic value of electrolyte imbalance has received little attention. Methods As a retrospective review, we screened inpatients with terminal cancer admitted between January 2017 and May 2019 to one hospice-palliative care unit. Clinical characteristics and laboratory results were obtained from medical records for multivariable Cox regression analysis of independant prognostic factors. Results Of the 487 patients who qualified, 15 (3%) were hypernatremic upon admission. Median survival time was 26 days. Parameters associated with shortened survival included male sex, advanced age (&gt; 70 years), lung cancer, poor performance status, elevated inflammatory markers, azotemia, impaired liver function, and hypernatermia. In a multivariable Cox proportional hazards model, male sex (hazard ratio [HR]=1.53, 95% confidence interval [CI]: 1.15–2.04), poor performance status (HR=1.45, 95% CI: 1.09–1.94), leukocytosis (HR=1.98, 95% CI: 1.47–2.66), hypoalbuminemia (HR=2.06, 95% CI: 1.49–2.73) and hypernatremia (HR=1.55, 95% CI: 1.18–2.03) emerged as significant predictors of poor prognosis. Conclusion Hypernatremia may be a useful gauge of prognosis in patients with terminal cancer. Further corroborative studies of large scale and prospective design are needed.</jats:p>