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Abstract: FR-PO664

Dysnatremia and Crude Mortality Rates: Evidence from the Sodium Metabolism and Management Experience (SoMME) Study

Session Information

Category: Fluid and Electrolytes

  • 902 Fluid and Electrolytes: Clinical

Authors

  • Umukoro, Peter Eloho, Marshfield Medical Center, Marshfield, Wisconsin, United States
  • Ishaq, Muhammad, Marshfield Medical Center, Marshfield, Wisconsin, United States
  • Olaiya, Babatunde, Marshfield Medical Center, Marshfield, Wisconsin, United States
  • Monga, Ridhima, Marshfield Medical Center, Marshfield, Wisconsin, United States
  • Lodhi, Fahad Aftab khan, Marshfield Medical Center, Marshfield, Wisconsin, United States
  • Dart, Richard A., Marshfield Clinic Research Institute, Marshfield, Wisconsin, United States

Group or Team Name

  • Sodium Metabolism and Management Experience (SoMME) Study Team
Background

Few studies have evaluated the association of dysnatremia with mortality among hospitalized patients. It is unclear if there is a reduced mortality rate among hospitalized patients with deranged sodium levels. We evaluated the association between sodium levels on admission with in-patient mortality, 30 day mortality and long term mortality. We hypothesized that mortality rates will vary by sodium levels with worse mortality outcomes at both extremes of sodium levels.

Methods

We obtained data from 39261 patients admitted between 2012-2016 patients who had a serum sodium on admission at a tertiary referral hospital in Central Wisconsin. We classified them into five categories based on their admitting serum sodium as severe low (<125), moderate low (125-129), mild low (130-134), normal (135-145) and high (>145). We obtained their vital status (alive or deceased) at end of hospital stay, within 30 days of admission and at the end of study period on December 31, 2017. Data were stratified by age and sex.

Results

There were 39261 patients (53% males, 97% whites) with age groups: <45 (12%), 45-64 (30%), 65-84 (44%) and >=85 years (14%). A U-shaped distribution of mortality is associated with serum sodium levels with mortality associated with high sodium levels being the greatest. Mortality associated with moderate low sodium levels almost approximate that of severe low sodium levels. These results were consistent across age and sex.

Conclusion

Higher crude mortality was seen in all patients with dysnatremia. Hypernatremia was associated with the worst mortality. Exploring mechanisms that contribute to death in dysnatremia, and researching if correcting sodium levels may prevent further deaths in the future.

Mortality during admission, within 30 days of admission or at end of study period by levels of admitting serum sodium level
Sodium on admission
mmol/L
Number of admissions
N
Deceased during admission*
N (%)
Deceased during admission or within 30 days of admission*
N (%)
Deceased at end of study*
N (%)
Severe low (<125)50626 (5.1)61 (12.1)240 (47.4)
Moderate low (125-129)121071 (5.9)152 (12.6)580 (47.9)
Mild low (130-134)8724282 (3.2)592 (6.8)2935 (33.6)
Normal (135-145)27813625 (2.3)1148 (4.1)5227 (18.8)
High (>145)100897 (9.6)187 (18.6)489 (48.5)
Total392611101 (2.8)2140 (5.4)9471 (24.1)

*p-value for trend is <0.0001 using the chi-square statistic for all outcomes.

Funding

  • Private Foundation Support