Related Experiment Video
Updated: Jan 28, 2026
Sodium Taurocholate Induced Severe Acute Pancreatitis in C57BL/6 Mice
Published on: June 28, 2021
Sodium Correction Rates and Associated Outcomes Among Patients With Severe Hyponatremia : A Retrospective Cohort
Dustin G Mark1, Mubarika Alavi2, Joshua R Nugent2
1Departments of Critical Care Medicine and Emergency Medicine, Kaiser Permanente, Oakland, California, and Division of Research, Kaiser Permanente Northern California, Pleasanton, California (D.G.M.).
Background:
Slow correction of severe hyponatremia is recommended to prevent osmotic demyelination syndrome but is associated with higher mortality.
Objective:
To examine the association between sodium correction rates and death or delayed neurologic events.
Design:
Retrospective cohort study.
Setting:
Twenty-one community hospitals of an integrated health system in northern California.
Patients:
Adults hospitalized with a serum sodium level of 120 mEq/L or lower between 2008 and 2023.
Intervention:
Maximum 24-hour rate of serum sodium correction (slow [<8 mEq/L], medium [8 to 12 mEq/L], or fast [>12 mEq/L; reference]).
Measurements:
The primary outcome was a composite of 90-day death or delayed neurologic events (new demyelination, paralysis, epilepsy, or altered consciousness between 3 and 90 days from admission). Standardized risk differences (RDs) were generated using targeted maximum likelihood estimation. Heterogeneity of effect was assessed across grades of predicted risk.
Results:
13 988 patients were hospitalized with severe hyponatremia during the study period (median age, 74 years; 63% female). Comorbidities included congestive heart failure (24%), liver disease (18%), alcohol dependence (14%), and metastatic cancer (10%). The primary outcome occurred in 3000 patients (21%); 90-day death occurred in 2554 (18%), and 90-day delayed neurologic events occurred in 587 (4%). Compared with slow 24-hour sodium correction, both medium (RD, -5.6 percentage points [95% CI, -7.1 to -4.0 percentage points]) and fast (RD, -9.0 percentage points [CI, -11.1 to -6.9 percentage points]) correction rates were associated with lower adjusted risk for the primary outcome. Risk differences increased with higher predicted risk, whereas risk ratios remained similar.
Limitations:
Residual confounding; outcome ascertainment using diagnostic codes.
Conclusion:
Faster sodium correction is associated with lower risk for 90-day death or delayed neurologic events. Treatment guidelines should be reexamined.
Primary Funding Source:
The Permanente Medical Group Rapid Analytics Unit Program.
More Related Videos
03:47A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
Published on: October 25, 2024
03:05Influence of Emotional Factors on the Efficacy of Acupuncture Treatment for Overweight Complicated with Hyperlipidemia: A Retrospective Cohort Study
Published on: November 21, 2025
Related Concept Videos
01:15Distance Corrections
01:20Power Factor Correction
02:24Predicting Reaction Outcomes
01:26Regulation of Sodium and Potassium
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
02:53Reaction Rate
The mathematical representation of the change in the concentration of reactants and products, over time, is the rate...