Dataset Information

Fluctuation of serum sodium and its impact on short and long-term mortality following acute pulmonary embolism.

ABSTRACT:

Background

Baseline hyponatremia predicts acute mortality following pulmonary embolism (PE). The natural history of serum sodium levels after PE and the relevance to acute and long-term mortality after the PE is unknown.

Methods

Clinical details of all patients (n?=?1023) admitted to a tertiary institution from 2000-2007 with acute PE were retrieved retrospectively. Serum sodium results from days 1, 3-4, 5-6, and 7 of admission were pre-specified and recorded. We excluded 250 patients without day-1 sodium or had <1 subsequent sodium assessment, leaving 773 patients as the studied cohort. There were 605 patients with normonatremia (sodium?135 mmol/L throughout admission), 57 with corrected hyponatremia (day-1 sodium<135 mmol/L, then normalized), 54 with acquired hyponatremia and 57 with persistent hyponatremia. Patients' outcomes were tracked from a state-wide death registry and analyses performed using multivariate-regression modelling.

Results

Mean (±standard deviation) day-1 sodium was 138.2±4.3 mmol/L. Total mortality (mean follow-up 3.6±2.5 years) was 38.8% (in-hospital mortality 3.2%). There was no survival difference between studied (n?=?773) and excluded (n?=?250) patients. Day-1 sodium (adjusted hazard ratio [aHR] 0.89, 95% confidence interval [CI] 0.83-0.95, p?=?0.001) predicted in-hospital death. Relative to normonatremia, corrected hyponatremia increased the risk of in-hospital death 3.6-fold (95% CI 1.20-10.9, p?=?0.02) and persistent hyponatremia increased the risk 5.6-fold (95% CI 2.08-15.0, p?=?0.001). Patients with either persisting or acquired hyponatremia had worse long-term survival than those who had corrected hyponatremia or had been normonatremic throughout (aHR 1.47, 95% CI 1.06-2.03, p?=?0.02).

Conclusion

Sodium fluctuations after acute PE predict acute and long-term outcome. Factors mediating the correction of hyponatremia following acute PE warrant further investigation.

SUBMITTER: Ng AC

PROVIDER: S-EPMC3631139 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Fluctuation of serum sodium and its impact on short and long-term mortality following acute pulmonary embolism.

Ng Austin Chin Chwan AC Chow Vincent V Yong Andy Sze Chiang AS Chung Tommy T Kritharides Leonard L

PloS one 20130419 4

<h4>Background</h4>Baseline hyponatremia predicts acute mortality following pulmonary embolism (PE). The natural history of serum sodium levels after PE and the relevance to acute and long-term mortality after the PE is unknown.<h4>Methods</h4>Clinical details of all patients (n = 1023) admitted to a tertiary institution from 2000-2007 with acute PE were retrieved retrospectively. Serum sodium results from days 1, 3-4, 5-6, and 7 of admission were pre-specified and recorded. We excluded 250 pati ...[more]

PMID: 23620796

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Dataset Information

Fluctuation of serum sodium and its impact on short and long-term mortality following acute pulmonary embolism.

Background

Methods

Results

Conclusion

Publications

Fluctuation of serum sodium and its impact on short and long-term mortality following acute pulmonary embolism.

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