The Economic Burden of Hyponatremia: Systematic Review And Meta-Analysis
Abstract Background Hyponatremia is the most common electrolyte abnormality observed in clinical practice. Several studies have demonstrated that hyponatremia is associated with an increased length of hospital stay and of hospital resource utilization. To clarify the impact of hyponatremia on the le...
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| creator | Corona, Giovanni, MD PhD Giuliani, Corinna, MD Parenti, Gabriele, MD PhD Colombo, Giorgio L., MSc Sforza, Alessandra, MD Maggi, Mario, MD PhD Forti, Gianni, MD Peri, Alessandro, MD, PhD |
| description | Abstract Background Hyponatremia is the most common electrolyte abnormality observed in clinical practice. Several studies have demonstrated that hyponatremia is associated with an increased length of hospital stay and of hospital resource utilization. To clarify the impact of hyponatremia on the length of hospitalization and costs, we performed a meta-analysis based on published studies that compared hospital length of stay and cost between patients with or without hyponatremia. Methods An extensive Medline, Embase and Cochrane search was performed to retrieve all studies published up to April 1st 2015, using the following words: "hyponatremia" or “hyponatraemia” AND "hospitalization" or “hospitalization”. A meta-analysis was performed including all studies comparing duration of hospitalization and hospital readmission rate in subjects with and without hyponatremia. Results Out of 444 retrieved articles, 46 studies satisfied the inclusion criteria encompassing a total of 3,940,042 patients; among these 757,763 (19·2%) were hyponatremic. Across all studies hyponatremia was associated with a significantly longer duration of hospitalization (3·30[2·90;3·71] mean days; p |
| doi_str_mv | 10.1016/j.amjmed.2016.03.007 |
| format | Article |
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Several studies have demonstrated that hyponatremia is associated with an increased length of hospital stay and of hospital resource utilization. To clarify the impact of hyponatremia on the length of hospitalization and costs, we performed a meta-analysis based on published studies that compared hospital length of stay and cost between patients with or without hyponatremia. Methods An extensive Medline, Embase and Cochrane search was performed to retrieve all studies published up to April 1st 2015, using the following words: "hyponatremia" or “hyponatraemia” AND "hospitalization" or “hospitalization”. A meta-analysis was performed including all studies comparing duration of hospitalization and hospital readmission rate in subjects with and without hyponatremia. Results Out of 444 retrieved articles, 46 studies satisfied the inclusion criteria encompassing a total of 3,940,042 patients; among these 757,763 (19·2%) were hyponatremic. Across all studies hyponatremia was associated with a significantly longer duration of hospitalization (3·30[2·90;3·71] mean days; p<0·000). Similar results were obtained when patients with associated morbidities were analyzed separately. Furthermore, hyponatremic patients had a higher risk of readmission after the first hospitalization (OR=1·32[1·18;1·48]; p<0·000). A meta-regression analysis showed that the hyponatremia-related length of hospital stay was higher in males (S=0·09[0·05;0·12];p=0·000 and I=-1·36[-3·03;0·32]; p=0·11) and in elderly patients (S=0·002[0·001;0·003];p<0·000 and I=0·89[0·83;0·97]; p<0·001). A negative association between serum [Na+ ] cut-off and duration of hospitalization was detected. No association between duration of hospitalization, serum [Na+ ] and associated morbidities was observed. Finally, when only US studies (n=8) were considered, hyponatremia was associated with up to $3,000 higher hospital costs/patient when compared to the cost of normonatremic subjects. Conclusions This meta-analysis confirms that hyponatremia is associated with a prolonged hospital length of stay, and higher risk of readmission. These observations suggest that hyponatremia may represent one important determinant of the hospitalization costs.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/j.amjmed.2016.03.007</identifier><identifier>PMID: 27059386</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Costs ; Hospitalization ; Hospitalization - economics ; Humans ; Hyponatremia ; Hyponatremia - economics ; Internal Medicine ; Length of Stay - economics ; Meta-analysis ; Morbidity ; Patient Readmission - economics ; Sodium ; Time Factors</subject><ispartof>The American journal of medicine, 2016-08, Vol.129 (8), p.823-835.e4</ispartof><rights>Elsevier Inc.</rights><rights>2016</rights><rights>Copyright © 2016. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Science Ltd. Aug 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c557t-68fc1035984bfb184cdc9b06435300e21ce027e0a180e2107580962bd17fe31e3</citedby><cites>FETCH-LOGICAL-c557t-68fc1035984bfb184cdc9b06435300e21ce027e0a180e2107580962bd17fe31e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002934316303151$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27059386$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Corona, Giovanni, MD PhD</creatorcontrib><creatorcontrib>Giuliani, Corinna, MD</creatorcontrib><creatorcontrib>Parenti, Gabriele, MD PhD</creatorcontrib><creatorcontrib>Colombo, Giorgio L., MSc</creatorcontrib><creatorcontrib>Sforza, Alessandra, MD</creatorcontrib><creatorcontrib>Maggi, Mario, MD PhD</creatorcontrib><creatorcontrib>Forti, Gianni, MD</creatorcontrib><creatorcontrib>Peri, Alessandro, MD, PhD</creatorcontrib><title>The Economic Burden of Hyponatremia: Systematic Review And Meta-Analysis</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Abstract Background Hyponatremia is the most common electrolyte abnormality observed in clinical practice. Several studies have demonstrated that hyponatremia is associated with an increased length of hospital stay and of hospital resource utilization. To clarify the impact of hyponatremia on the length of hospitalization and costs, we performed a meta-analysis based on published studies that compared hospital length of stay and cost between patients with or without hyponatremia. Methods An extensive Medline, Embase and Cochrane search was performed to retrieve all studies published up to April 1st 2015, using the following words: "hyponatremia" or “hyponatraemia” AND "hospitalization" or “hospitalization”. A meta-analysis was performed including all studies comparing duration of hospitalization and hospital readmission rate in subjects with and without hyponatremia. Results Out of 444 retrieved articles, 46 studies satisfied the inclusion criteria encompassing a total of 3,940,042 patients; among these 757,763 (19·2%) were hyponatremic. Across all studies hyponatremia was associated with a significantly longer duration of hospitalization (3·30[2·90;3·71] mean days; p<0·000). Similar results were obtained when patients with associated morbidities were analyzed separately. Furthermore, hyponatremic patients had a higher risk of readmission after the first hospitalization (OR=1·32[1·18;1·48]; p<0·000). A meta-regression analysis showed that the hyponatremia-related length of hospital stay was higher in males (S=0·09[0·05;0·12];p=0·000 and I=-1·36[-3·03;0·32]; p=0·11) and in elderly patients (S=0·002[0·001;0·003];p<0·000 and I=0·89[0·83;0·97]; p<0·001). A negative association between serum [Na+ ] cut-off and duration of hospitalization was detected. No association between duration of hospitalization, serum [Na+ ] and associated morbidities was observed. Finally, when only US studies (n=8) were considered, hyponatremia was associated with up to $3,000 higher hospital costs/patient when compared to the cost of normonatremic subjects. Conclusions This meta-analysis confirms that hyponatremia is associated with a prolonged hospital length of stay, and higher risk of readmission. These observations suggest that hyponatremia may represent one important determinant of the hospitalization costs.</description><subject>Costs</subject><subject>Hospitalization</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Hyponatremia</subject><subject>Hyponatremia - economics</subject><subject>Internal Medicine</subject><subject>Length of Stay - economics</subject><subject>Meta-analysis</subject><subject>Morbidity</subject><subject>Patient Readmission - economics</subject><subject>Sodium</subject><subject>Time Factors</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUGL1TAQx4Mo7tvVbyBS8OKldaZp2tSD8FxWn7AiuOs5pOkUU9vmmbRKv_2mvF2EvXgKf_KbyeQ3jL1CyBCwfNdneuxHarM8pgx4BlA9YTsUQqQVlvlTtgOAPK15wc_YeQh9jFCL8jk7yysQNZfljh1uf1JyZdzkRmuSj4tvaUpclxzWo5v07Gm0-n1ys4aZRj1H5Dv9sfQ32U9t8pVmne4nPazBhhfsWaeHQC_vzwv249PV7eUhvf72-cvl_jo1QlRzWsrOIHBRy6LpGpSFaU3dQFlwwQEoR0OQVwQa5ZagEhLqMm9arDriSPyCvT31PXr3e6Ewq9EGQ8OgJ3JLULGuAomYY0TfPEJ7t_g470ahrIDLuohUcaKMdyF46tTR21H7VSGozbTq1cm02kwr4CqajmWv75svzXb3UPSgNgIfTgBFG9GZV8FYmgy11pOZVevs_1543MAMdrJGD79opfDvLyrkCtTNtu1t2Vhy4CiQ3wGFIKLF</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Corona, Giovanni, MD PhD</creator><creator>Giuliani, Corinna, MD</creator><creator>Parenti, Gabriele, MD PhD</creator><creator>Colombo, Giorgio L., MSc</creator><creator>Sforza, Alessandra, MD</creator><creator>Maggi, Mario, MD PhD</creator><creator>Forti, Gianni, MD</creator><creator>Peri, Alessandro, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier Sequoia S.A</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20160801</creationdate><title>The Economic Burden of Hyponatremia: Systematic Review And Meta-Analysis</title><author>Corona, Giovanni, MD PhD ; Giuliani, Corinna, MD ; Parenti, Gabriele, MD PhD ; Colombo, Giorgio L., MSc ; Sforza, Alessandra, MD ; Maggi, Mario, MD PhD ; Forti, Gianni, MD ; Peri, Alessandro, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c557t-68fc1035984bfb184cdc9b06435300e21ce027e0a180e2107580962bd17fe31e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Costs</topic><topic>Hospitalization</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Hyponatremia</topic><topic>Hyponatremia - economics</topic><topic>Internal Medicine</topic><topic>Length of Stay - economics</topic><topic>Meta-analysis</topic><topic>Morbidity</topic><topic>Patient Readmission - economics</topic><topic>Sodium</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Corona, Giovanni, MD PhD</creatorcontrib><creatorcontrib>Giuliani, Corinna, MD</creatorcontrib><creatorcontrib>Parenti, Gabriele, MD PhD</creatorcontrib><creatorcontrib>Colombo, Giorgio L., MSc</creatorcontrib><creatorcontrib>Sforza, Alessandra, MD</creatorcontrib><creatorcontrib>Maggi, Mario, MD PhD</creatorcontrib><creatorcontrib>Forti, Gianni, MD</creatorcontrib><creatorcontrib>Peri, Alessandro, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Corona, Giovanni, MD PhD</au><au>Giuliani, Corinna, MD</au><au>Parenti, Gabriele, MD PhD</au><au>Colombo, Giorgio L., MSc</au><au>Sforza, Alessandra, MD</au><au>Maggi, Mario, MD PhD</au><au>Forti, Gianni, MD</au><au>Peri, Alessandro, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Economic Burden of Hyponatremia: Systematic Review And Meta-Analysis</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>129</volume><issue>8</issue><spage>823</spage><epage>835.e4</epage><pages>823-835.e4</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Abstract Background Hyponatremia is the most common electrolyte abnormality observed in clinical practice. Several studies have demonstrated that hyponatremia is associated with an increased length of hospital stay and of hospital resource utilization. To clarify the impact of hyponatremia on the length of hospitalization and costs, we performed a meta-analysis based on published studies that compared hospital length of stay and cost between patients with or without hyponatremia. Methods An extensive Medline, Embase and Cochrane search was performed to retrieve all studies published up to April 1st 2015, using the following words: "hyponatremia" or “hyponatraemia” AND "hospitalization" or “hospitalization”. A meta-analysis was performed including all studies comparing duration of hospitalization and hospital readmission rate in subjects with and without hyponatremia. Results Out of 444 retrieved articles, 46 studies satisfied the inclusion criteria encompassing a total of 3,940,042 patients; among these 757,763 (19·2%) were hyponatremic. Across all studies hyponatremia was associated with a significantly longer duration of hospitalization (3·30[2·90;3·71] mean days; p<0·000). Similar results were obtained when patients with associated morbidities were analyzed separately. Furthermore, hyponatremic patients had a higher risk of readmission after the first hospitalization (OR=1·32[1·18;1·48]; p<0·000). A meta-regression analysis showed that the hyponatremia-related length of hospital stay was higher in males (S=0·09[0·05;0·12];p=0·000 and I=-1·36[-3·03;0·32]; p=0·11) and in elderly patients (S=0·002[0·001;0·003];p<0·000 and I=0·89[0·83;0·97]; p<0·001). A negative association between serum [Na+ ] cut-off and duration of hospitalization was detected. No association between duration of hospitalization, serum [Na+ ] and associated morbidities was observed. Finally, when only US studies (n=8) were considered, hyponatremia was associated with up to $3,000 higher hospital costs/patient when compared to the cost of normonatremic subjects. Conclusions This meta-analysis confirms that hyponatremia is associated with a prolonged hospital length of stay, and higher risk of readmission. These observations suggest that hyponatremia may represent one important determinant of the hospitalization costs.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27059386</pmid><doi>10.1016/j.amjmed.2016.03.007</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Costs Hospitalization Hospitalization - economics Humans Hyponatremia Hyponatremia - economics Internal Medicine Length of Stay - economics Meta-analysis Morbidity Patient Readmission - economics Sodium Time Factors |
| title | The Economic Burden of Hyponatremia: Systematic Review And Meta-Analysis |
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