Outcomes of Hospital-Acquired Hypernatremia.

Hospital-acquired hypernatremia is highly prevalent, overlooked and is associated with unfavorable consequences. There are limited studies examining the outcomes and discharge dispositions of various levels of hospital-acquired hypernatremia in patients with or without chronic kidney disease.We conducted an observational retrospective cohort study, and we analyzed the data of 1,728,141 million patients extracted from the Cerner Health Facts database (January 1st 2000- June 30 th 2018). In this report we investigated the association between hospital-acquired hypernatremia (serum sodium (Na) levels>145 mEq/L) and in-hospital mortality or discharge dispositions with kidney function status at admission using adjusted multinomial regression models.Of all hospitalized patients, 6% developed hypernatremia after hospital admission. Incidence of in-hospital mortality was 12% and 1% in hyper- and normonatremic patients, respectively. The risk of all outcomes was significantly greater for serum Na >145 mEq/L compared to the reference interval (serum Na: 135-145 mEq/L). In hypernatremic patients, odds ratios (ORs) (95% confidence interval) for in-hospital mortality, discharge to hospice and discharge to nursing facilities were 14.04 (13.71-14.38), 4.35 (4.14-4.57) and 3.88 (3.82-3.94), respectively (p<0.001, for all). Patients with estimated glomerular filtration rate (CKD-EPI) 60-89 mL/min/1.73 m2 and normonatremia had the lowest OR for in-hospital mortality (1.60 [1.52-1.70]).Hospital-acquired hypernatremia is associated with in-hospital mortality as well as discharge to hospice or to nursing facility in all stages of CKD.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology.

Citation

Soraya Arzhan, Maria-Eleni Roumelioti, Igor Litvinovich, Cristian G Bologa, Mark L Unruh. Outcomes of Hospital-Acquired Hypernatremia. Clinical journal of the American Society of Nephrology : CJASN. 2023 Sep 18

PMID: 37722368

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