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Abstract: FR-PO285

Hyponatremia Associated with Development of Sepsis

Session Information

Category: Fluid and Electrolytes

  • 902 Fluid and Electrolytes: Clinical

Authors

  • Kulvichit, Win, University of Pittsburgh School of Medicine, Pittsburgh, United States
  • Formeck, Cassandra Lynn, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Priyanka, Priyanka, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Joyce, Emily Lauren, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Badavanahalli Rajashekar, Shashank, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Moritz, Michael L., Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Ayus, Juan Carlos, Renal Consultants of Houston, Houston, Texas, United States
  • Kellum, John A., University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
Background

Hyponatremia is a common electrolyte imbalance in critically ill patients and is associated with increased mortality and morbidity. Experimental evidence suggest that hyponatremia may compromise immune cell function. Thus, we sought to determine whether an association between hyponatremia and sepsis was present in critically ill adults and children.

Methods

Data was obtained from databases of 46,329 adult and 12,806 pediatric patients from the ICUs of UPMC hospitals. We included patients with a Na value measured within 6 hours of ICU admission and excluded patients with sepsis on admission. We analyzed the association between hyponatremia by severity (serum Na <135 mEq/L, mild; 130-134 mEq/L, moderate; 125-129 mEq/L, severe <125 mEq/L) and the development of sepsis over 7 days following the occurrence of hyponatremia.

Results

A total number of 39,403 adults and 3,977 children were included in the analysis. 40% of adult patients and 14% of pediatric patients had hyponatremia with rates of sepsis of 24% and 33% respectively. Critically ill patients with hyponatremia were at increased risk of developing sepsis (RR 2.43 for adult, RR 1.34 for pediatric patients). Risk for developing sepsis increased with the severity of hyponatremia in adults.

Conclusion

Critically ill patients with hyponatremia are at increased risk for developing sepsis. Further analysis is required to understand the nature of this relationship and to better control for confounding.

Unadjusted Relative Risk of Developing Sepsis within 3 days Following Exposure to Varying Degrees of Hyponatremia in Adult and Pediatric ICU Patients