Dysnatremia in hospitalized patients: Prevalence and impact on outcome
Ibrahim Mokhtar, Abbas Al Makramy
Background/aim: Sodium is the major extracellular cation in the body and is therefore one of the most important osmotic ally active solutes. Disturbance of sodium balance, referred to as dysnatremia is a frequent finding in adults in the hospital in-patient setting, and accounts for the bulk of electrolyte disturbances in this patient population. Abnormal serum sodium concentrations are known to adversely affect physiologic function and an increasing body of evidence suggests that dysnatremia may be associated with adverse outcome. The aim of this study was to assess the prevalence of dysnatremia among hospitalized patient in King Khalid Hospital, Najera, and KSA (KKHN) on admission and to access the relation of the initial serum sodium concentration with mortality and length of stay (LOS) in hospitalized patients. Material and methods: We conducted retrospective observational randomized study on random sample of patients admitted to inpatients departments during one year period starting 01.08.2014 up to 31.07.2015 through medical records review. terminally ill patients, those with advanced malignancy and very old patients above 75 years old were excluded (No. 740 patients including 483 males and 257 females). Serum sodium on admission, length of stay and outcome beside basic demographic data were extracted from medical records. Results: 17.7 % of the study subjects (No. 131) had dysnatremia. The prevalence of hyponatremia is significantly higher than Hypernatremia (16.2 % vs. 1.48 % P < 0.005). Patients with Hypernatremia had significantly higher mortality rate than both patients with hyponatremia and normonatremia (36.3 % vs., 3.3 vs. 1.64 % respectively P< 0.005). Patients with hyponatremia had higher mortality rate than patients with normonatremia (3.3 % vs. 1.64 %), however the difference is not statistically significant (P > 0.005). Patients with normonatremia had longer mean LOS, followed by patients with hyponatremia then patients with Hypernatremia (5.16 vs. 4.74 vs. 2.67 days), however the difference is not statistically significant (P> 0.005) Conclusion: The prevalence of dysnatremia in hospitalized patients in King Khalid Hospital, Najran, Saudi Arabia is comparable the documented prevalence in other studies. The prevalence of Hypernatremia is much less than hyponatremia, however it has significantly higher mortality rates. Patients with dysnatremia has shorter inpatient LOS, which may be attributed to higher mortality, however this impact is not statistically significant. Further work is needed to define the risk factors for the higher mortality in patients with dysnatremia.