The prevalence and mortality of hyponatremia is seriously underestimated in Chinese general medical patients: an observational retrospective study

Abstract

BackgroundHyponatremia (serum sodium concentration < 135 mmol/L) is the most common electrolyte abnormality and is a predictor of the mortality of hospitalized patients in Western countries. However, hyponatremia data are lacking in Asian countries. Here we evaluate the epidemiology and mortality of hyponatremia in general medical hospitalized patients in China.MethodsThis is a cohort study of 154,378 adults who were hospitalized between 2008 and 2012 at a teaching hospital in Beijing. We identified hospital patients with hyponatremia and calculated the prevalence and in-hospital mortality of hyponatremia. We also conducted a comprehensive retrospective review of the medical records of patients who had severe hyponatremia (serum sodium <120 mmol/L) during hospitalization in 2012.ResultsThe overall prevalence of hyponatremia at some point during hospitalization was 17.5% (26,990 patients), but only 0.26% (394 patients) of cases were identified with the diagnostic code of hyponatremia. Hyponatremia was more common in patients with infectious disease, cancer, or cardiovascular disease as the primary reason for hospitalization based on discharge diagnosis, with prevalences of 33.0, 25.9 and 24.9%, respectively. The in-hospital mortality was 0.48% amongst patients without hyponatremia compared to 3.57 and 20.23% in patients with serum sodium levels of 130–134 and <120 mmol/L, resulting in multivariable adjusted odds ratios (ORs) of 4.8 (95% CI 4.3–5.4) and 32.9 (95% CI 25.2–42.3), respectively. The mortality risk increased with increasing severity of hyponatremia in all diagnostic groups. After the multivariate adjustment, only the Charlson Comorbidity Index and age were independently associated with death risk (OR 1.36, 95% CI 1.14–1.64 and OR 1.04, 95% CI 1.00–1.09, respectively) in the patients with severe hyponatremia.ConclusionsHyponatremia is highly prevalent among Chinese hospitalized patients and is associated with increased in-hospital mortality risk. Physicians should raise awareness to improve the prognosis of hyponatremia.Electronic supplementary materialThe online version of this article (10.1186/s12882-017-0744-x) contains supplementary material, which is available to authorized users.

Survival and Mortality of Patients with Hyponatremia in Intensive Care Units: A Retrospective Study of 327 Patients Hospitalized at Sylvanus Olympio University Hospital

“…In our series, the frequency of hyponatremia in resuscitation services was 24.16%. Hao et al found a prevalence of 17.5% in internal medicine hospitalization [8], like Andreas et al in 2014 in a multicenter cohort performed in the United States, France and Switzerland, which had a prevalence of 18% [17]. These data contrast with those of Traore et al, who had found a prevalence of 48% at the Abidjan Heart Institute [10].…”

“…Its difficulties of care are related to the plurality of mechanisms of installation with as major risk of complications: an irreversible neurological attack [1]. Epidemiological data are diversified according to different regions of the world [5][6][7][8]. In the western series, there is a prevalence of 18% in a multicenter study between France, Switzerland, and the United States [9].…”

Clinico-etiological Profile of Seizure Disorder among Adults Admitted to Tertiary Care Hospital of Nepal

“…Therefore, before considering the use of the currently available cystic drugs albendazole and praziquantel, appropriate symptomatic treatment should always be The other most common cause of seizures in our study is hyponatremia. According to a report in the United States, the prevalence of hyponatremia in the emergency department was 2.7%, and a survey in Taiwan showed 2.9% 13 . A decrease in serum sodium concentration can trigger systemic tonic-clonic seizures, often associated with confusion and loss of consciousness.…”

Salt need needs investigation

“…Dietary Na deficiency is rare, occurring in extreme cases of eating or drinking disorders (110) . Hyponatraemia, especially frequent among the institutionalised, hospitalised and the elderly, is associated with multiple pathologies, including of mood, and with mortality, and it is due to multiple fluid and electrolyte disorders (111,112) . Hyponatraemia is also frequent in physical exertion, due to Na loss in sweat or overhydration that leaches Na, particularly among less trained athletes.…”

“…Hyponatraemia is also frequent in physical exertion, due to Na loss in sweat or overhydration that leaches Na, particularly among less trained athletes. Nevertheless, athletes can be in mortal danger of hyponatraemic crisis because its diagnosis requires astute health workers (78,111,112) . These counsellors are necessary because unlike animals, humans seek salt to please their palate, but not to save their life (78) .…”