Hypernatremia in Hospitalized Patients: A Large Population-Based Study.

Area of Science:

• Nephrology
• Internal Medicine
• Critical Care Medicine

Background:

• Hypernatremia is a common electrolyte disturbance in hospitalized individuals.
• The precise impact of hypernatremia on patient outcomes remains debated.
• This study investigates hypernatremia's association with mortality and discharge status, considering kidney function and age.

Purpose of the Study:

• To examine the relationship between hypernatremia and in-hospital mortality.
• To assess the association of hypernatremia with discharge dispositions.
• To determine if kidney function and age modify the impact of hypernatremia on outcomes.

Main Methods:

• An observational study utilizing data from 1.9 million hospitalized patients (2000-2018).
• Analysis of serum sodium levels, estimated glomerular filtration rate (eGFR), age, in-hospital mortality, and discharge dispositions.
• Adjusted multinomial regression models were employed to assess associations.

Main Results:

• 3% of patients presented with hypernatremia (serum sodium >145 mEq/L).
• In-hospital mortality was 12% for hypernatremic patients versus 2% for normonatremic patients.
• Elevated sodium levels (>155 mEq/L) showed significantly increased odds of mortality and discharge to a nursing facility, with effect modification by eGFR and age.

Conclusions:

• Hypernatremia is a significant predictor of in-hospital mortality and adverse discharge dispositions.
• The risk associated with hypernatremia is most pronounced at serum sodium levels exceeding 155 mEq/L.
• Findings underscore the importance of managing hypernatremia and suggest further research into protocolized treatment.