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Relationship between serum sodium levels and all-cause mortality in congestive heart failure patients: A
Shixuan Peng1, Jianxing Peng2, Lianju Yang3
1Department of Oncology, Graduate Collaborative Training Base of The First People's Hospital of Xiangtan City, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Insights
Serum sodium levels show a U-shaped relationship with mortality in congestive heart failure (CHF) patients. Both low and high sodium levels are linked to increased risks of death over various timeframes.
Area of Science:
- Cardiology
- Nephrology
- Intensive Care Medicine
Background:
- The association between serum sodium levels and mortality in congestive heart failure (CHF) patients remains understudied.
- Existing research presents conflicting views on the non-linear correlation between serum sodium levels and mortality in heart failure patients.
Purpose of the Study:
- To investigate the relationship between serum sodium levels and all-cause mortality in patients with CHF.
- To control for confounding factors when assessing the impact of serum sodium on CHF patient mortality.
Main Methods:
- Utilized the publicly accessible Mimic III database for patient data.
- Collected demographic, laboratory, comorbidity, and vital sign data using the ICU Admission Scoring System.
- Employed Cox proportional risk analysis, smooth curve fitting, and Kaplan-Meier survival curves to analyze data.
Main Results:
- A turning point for serum sodium levels was identified at 137.5 mmol/L concerning all-cause mortality.
- Lower serum sodium levels (<137.5 mmol/L) were associated with increased risks of 30-day, 90-day, 365-day, and 4-year all-cause mortality.
- Higher serum sodium levels (≥137.5 mmol/L) were also linked to increased risks of all-cause mortality across the same timeframes.
Conclusions:
- Serum sodium levels exhibit a U-shaped association with all-cause mortality in CHF patients.
- Both hyponatremia and hypernatremia are associated with elevated risks of short-, medium-, and long-term all-cause mortality in individuals with CHF.
Background:
The relationship between serum sodium levels and mortality in congestive heart failure (CHF) patients has not been well-studied previously. The non-linear correlation between serum sodium levels and mortality in patients with heart failure is currently controversial, and the relationship between different serum sodium levels and mortality is disputed. The goal of this study is to look into the relationship between serum sodium levels and all-cause mortality in people with CHF after controlling for other factors.
Methods:
The publicly accessible Mimic III database was the source of data for our study. We use the ICU Admission Scoring System to collect demographic data, laboratory findings, comorbidities, vital signs, and scoring information for each patient. Cox proportional risk analysis, smooth curve fitting, and the Kaplan-Meier survival curve were used to assess the relationship between baseline sodium levels and all-cause mortality in CHF patients.
Results:
The segmentation regression model discovered a turning point value of serum sodium levels (137.5 mmol/L) between serum sodium levels and all-cause mortality. According to the results of the fully adjusted Cox proportional hazard model, lower serum sodium levels (<137.5 mmol/L) were associated with an increased risk of 30, 90, 365-day, and 4-year all-cause deaths. The HRs and 95th confidence intervals were 0.96 (0.94, 0.99), 0.96 (0.94, 0.99), 0.96 (0.94, 0.98), and 0.96 (0.95, 0.98), respectively; the higher serum sodium levels (≥137.5 mmol/L) were related to an associated multiplied risk of 30, 90, 365-day, and 4-year all-cause deaths; the HRs and 95th confidence intervals were 1.02 (1.00, 1.05), 1.02 (1.00, 1.04), 1.02 (1.00, 1.03), and 1.02 (1.00, 1.03), respectively.
Conclusion:
Serum sodium levels were u-shaped about all-cause mortality. In individuals with CHF, serum sodium levels are linked to an elevated risk of short-, medium-, and long-term all-cause mortality.
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