Association between hypernatraemia acquired in the ICU and mortality: a cohort study

Area of Science:

• Critical Care Medicine
• Nephrology
• Internal Medicine

Background:

• Intensive care unit-acquired hypernatraemia (IAH) is a frequent complication.
• Understanding its prevalence and impact on patient outcomes is crucial for improving critical care.

Purpose of the Study:

• To determine the prevalence of IAH in a large cohort of ICU patients.
• To investigate the association between IAH and patient mortality.

Main Methods:

• Retrospective analysis of a prospectively collected database from 12 ICUs.
• Inclusion criteria: patients with ICU stay >48 hours and normal serum sodium on admission.
• IAH defined as serum sodium >145 mmol/L occurring ≥24 hours after ICU admission.

Main Results:

• IAH occurred in 15.3% of eligible patients (11.1% mild, 4.2% moderate to severe).
• Independent predictors of IAH included male gender, higher SAPS II score, and organ failure.
• IAH was strongly associated with increased hospital and ICU mortality, with adjusted subdistribution hazard ratios of 2.03 for mild and 2.67 for moderate to severe IAH.

Conclusions:

• IAH is a prevalent and significant complication in the ICU.
• IAH is independently associated with increased mortality, underscoring the need for vigilant monitoring and management.