Diagnostic Workup and Outcome in Patients with Profound Hyponatremia
Hyponatremia is the most common electrolyte disorder. A proper diagnosis is important for its successful management, especially in profound hyponatremia. The European hyponatremia guidelines point at sodium and osmolality measurement in plasma and urine, and the clinical evaluation of volume status...
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| Veröffentlicht in: | Journal of clinical medicine 2023-05, Vol.12 (10), p.3567 |
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| creator | Isaak, Johann Boesing, Maria Potasso, Laura Lenherr, Christoph Luethi-Corridori, Giorgia Leuppi, Joerg D Leuppi-Taegtmeyer, Anne B |
| description | Hyponatremia is the most common electrolyte disorder. A proper diagnosis is important for its successful management, especially in profound hyponatremia. The European hyponatremia guidelines point at sodium and osmolality measurement in plasma and urine, and the clinical evaluation of volume status as the minimum diagnostic workup for the diagnosis of hyponatremia. We aimed to determine compliance with guidelines and to investigate possible associations with patient outcomes. In this retrospective study, we analysed the management of 263 patients hospitalised with profound hyponatremia at a Swiss teaching hospital between October 2019 and March 2021. We compared patients with a complete minimum diagnostic workup (D-Group) to patients without (N-Group). A minimum diagnostic workup was performed in 65.5% of patients and 13.7% did not receive any treatment for hyponatremia or an underlying cause. The twelve-month survival did not show statistically significant differences between the groups (HR 1.1, 95%-CI: 0.58-2.12,
-value 0.680). The chance of receiving treatment for hyponatremia was higher in the D-group vs. N-Group (91.9% vs. 75.8%,
-value < 0.001). A multivariate analysis showed significantly better survival for treated patients compared to not treated (HR 0.37, 95%-CI: 0.17-0.78,
-value 0.009). More efforts should be made to ensure treatment of profound hyponatremia in hospitalised patients. |
| doi_str_mv | 10.3390/jcm12103567 |
| format | Article |
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-value 0.680). The chance of receiving treatment for hyponatremia was higher in the D-group vs. N-Group (91.9% vs. 75.8%,
-value < 0.001). A multivariate analysis showed significantly better survival for treated patients compared to not treated (HR 0.37, 95%-CI: 0.17-0.78,
-value 0.009). More efforts should be made to ensure treatment of profound hyponatremia in hospitalised patients.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12103567</identifier><identifier>PMID: 37240673</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Care and treatment ; Clinical medicine ; Clinical practice guidelines ; Comorbidity ; Data collection ; Diagnosis ; Etiology ; Geriatrics ; Hospital patients ; Hospitalization ; Hospitals ; Hyponatremia ; Intensive care ; Medicine ; Mortality ; Patient outcomes ; Patients ; Plasma ; Sodium ; Software ; Statistical analysis ; Urine</subject><ispartof>Journal of clinical medicine, 2023-05, Vol.12 (10), p.3567</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-efb3c3c8a5adf8ccf67a266e626be23c02b027c40ea15c587fd862b71a05bcfd3</citedby><cites>FETCH-LOGICAL-c477t-efb3c3c8a5adf8ccf67a266e626be23c02b027c40ea15c587fd862b71a05bcfd3</cites><orcidid>0000-0002-5554-0675 ; 0009-0001-4518-4320 ; 0000-0002-9956-3895 ; 0000-0001-8605-1893</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219478/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219478/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37240673$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Isaak, Johann</creatorcontrib><creatorcontrib>Boesing, Maria</creatorcontrib><creatorcontrib>Potasso, Laura</creatorcontrib><creatorcontrib>Lenherr, Christoph</creatorcontrib><creatorcontrib>Luethi-Corridori, Giorgia</creatorcontrib><creatorcontrib>Leuppi, Joerg D</creatorcontrib><creatorcontrib>Leuppi-Taegtmeyer, Anne B</creatorcontrib><title>Diagnostic Workup and Outcome in Patients with Profound Hyponatremia</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Hyponatremia is the most common electrolyte disorder. A proper diagnosis is important for its successful management, especially in profound hyponatremia. The European hyponatremia guidelines point at sodium and osmolality measurement in plasma and urine, and the clinical evaluation of volume status as the minimum diagnostic workup for the diagnosis of hyponatremia. We aimed to determine compliance with guidelines and to investigate possible associations with patient outcomes. In this retrospective study, we analysed the management of 263 patients hospitalised with profound hyponatremia at a Swiss teaching hospital between October 2019 and March 2021. We compared patients with a complete minimum diagnostic workup (D-Group) to patients without (N-Group). A minimum diagnostic workup was performed in 65.5% of patients and 13.7% did not receive any treatment for hyponatremia or an underlying cause. The twelve-month survival did not show statistically significant differences between the groups (HR 1.1, 95%-CI: 0.58-2.12,
-value 0.680). The chance of receiving treatment for hyponatremia was higher in the D-group vs. N-Group (91.9% vs. 75.8%,
-value < 0.001). A multivariate analysis showed significantly better survival for treated patients compared to not treated (HR 0.37, 95%-CI: 0.17-0.78,
-value 0.009). More efforts should be made to ensure treatment of profound hyponatremia in hospitalised patients.</description><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Clinical practice guidelines</subject><subject>Comorbidity</subject><subject>Data collection</subject><subject>Diagnosis</subject><subject>Etiology</subject><subject>Geriatrics</subject><subject>Hospital patients</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Hyponatremia</subject><subject>Intensive care</subject><subject>Medicine</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Plasma</subject><subject>Sodium</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>Urine</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkctPGzEQxq2qiCDIiXu1Ui-VqlA_1o-cKgSUVEKCQyuOlnfWTpzu2qm9W8R_X0e8AsI-2Br_5vPMfAgdE3zC2Bx_W0NPKMGMC_kBHVAs5QwzxT7u3CdomvMal6VUTYncRxMmaY2FZAfo_NybZYh58FDdxvRn3FQmtNX1OEDsbeVDdWMGb8OQqzs_rKqbFF0cC7G438RghmR7b47QnjNdttPH8xD9_nHx62wxu7q-_Hl2ejWDWsphZl3DgIEy3LROATghDRXCCioaSxlg2mAqocbWEA5cSdcqQRtJDOYNuJYdou8Pupux6W0LpaxkOr1JvjfpXkfj9euX4Fd6Gf9pgimZ11IVhS-PCin-HW0edO8z2K4zwcYxa6ooxrSu6Rb9_AZdxzGF0l-hihoncyJfqKXprPbBxfIxbEX1qeRUcKn4vFAn71Blt2V8EIN1vsRfJXx9SIAUc07WPTdJsN4ar3eML_Sn3bk8s082s_8XzKf5</recordid><startdate>20230519</startdate><enddate>20230519</enddate><creator>Isaak, Johann</creator><creator>Boesing, Maria</creator><creator>Potasso, Laura</creator><creator>Lenherr, Christoph</creator><creator>Luethi-Corridori, Giorgia</creator><creator>Leuppi, Joerg D</creator><creator>Leuppi-Taegtmeyer, Anne B</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5554-0675</orcidid><orcidid>https://orcid.org/0009-0001-4518-4320</orcidid><orcidid>https://orcid.org/0000-0002-9956-3895</orcidid><orcidid>https://orcid.org/0000-0001-8605-1893</orcidid></search><sort><creationdate>20230519</creationdate><title>Diagnostic Workup and Outcome in Patients with Profound Hyponatremia</title><author>Isaak, Johann ; 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A proper diagnosis is important for its successful management, especially in profound hyponatremia. The European hyponatremia guidelines point at sodium and osmolality measurement in plasma and urine, and the clinical evaluation of volume status as the minimum diagnostic workup for the diagnosis of hyponatremia. We aimed to determine compliance with guidelines and to investigate possible associations with patient outcomes. In this retrospective study, we analysed the management of 263 patients hospitalised with profound hyponatremia at a Swiss teaching hospital between October 2019 and March 2021. We compared patients with a complete minimum diagnostic workup (D-Group) to patients without (N-Group). A minimum diagnostic workup was performed in 65.5% of patients and 13.7% did not receive any treatment for hyponatremia or an underlying cause. The twelve-month survival did not show statistically significant differences between the groups (HR 1.1, 95%-CI: 0.58-2.12,
-value 0.680). The chance of receiving treatment for hyponatremia was higher in the D-group vs. N-Group (91.9% vs. 75.8%,
-value < 0.001). A multivariate analysis showed significantly better survival for treated patients compared to not treated (HR 0.37, 95%-CI: 0.17-0.78,
-value 0.009). More efforts should be made to ensure treatment of profound hyponatremia in hospitalised patients.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37240673</pmid><doi>10.3390/jcm12103567</doi><orcidid>https://orcid.org/0000-0002-5554-0675</orcidid><orcidid>https://orcid.org/0009-0001-4518-4320</orcidid><orcidid>https://orcid.org/0000-0002-9956-3895</orcidid><orcidid>https://orcid.org/0000-0001-8605-1893</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Care and treatment Clinical medicine Clinical practice guidelines Comorbidity Data collection Diagnosis Etiology Geriatrics Hospital patients Hospitalization Hospitals Hyponatremia Intensive care Medicine Mortality Patient outcomes Patients Plasma Sodium Software Statistical analysis Urine |
| title | Diagnostic Workup and Outcome in Patients with Profound Hyponatremia |
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