Abstract: TH-PO327
Analysis of Sodium in Inpatients, Outcomes, and Nephrology Engagement (ASIN-ONE): A Study on Nephrology Referral Timing in Hyponatremic Adult Patients at a Tertiary Hospital
Session Information
- Sodium, Potassium, and Volume Disorders: Clinical
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Herrera, Charles Michael Te, Philippine General Hospital, Manila, Metro Manila, Philippines
- Qua, Andrew Timothy, Philippine General Hospital, Manila, Metro Manila, Philippines
- Santos, Adrian Lucas, Philippine General Hospital, Manila, Metro Manila, Philippines
- Lao, Janice Jill, Philippine General Hospital, Manila, Metro Manila, Philippines
Background
Hyponatremia is the most common inpatient electrolyte abnormality. Earlier referral to a nephrologist may shorten hospitalization and improve patient survival.
Methods
This was a 6-month retrospective cohort study of nephrology referrals in a tertiary hospital. We analyzed four groups based on days from admission to referral (<1d, 1-<3d, 3-7d, and >7d) for length of stay, in-hospital mortality, and hyponatremia resolution. Kaplan-Meier curves and Cox proportional hazard regression were done.
Results
Of the 800 patients analyzed, overall mortality was 31.87%. Those referred <1d from admission had significantly shorter hospitalization (median 8.41 vs. 24.57 days) and significantly lower mortality (26.04% vs. 51.35%) than the >7d group. The 3-7d group had a higher risk of death than the <1d group (HR 2.91, 95% CI, 1.94–4.36). Kaplan-Meier curves revealed decreased survival in patients referred >72 hours from admission. There was no significant difference across groups in terms of normonatremia attainment prior to discharge or mortality.
Conclusion
Earlier nephrology referral was associated with decreased hospital stay and mortality. Significant divergence in in-hospital mortality was seen in hyponatremic patients referred more than 72 hours from admission.
| Hospital Outcomes | Timing of Referral from Admission (Days) | ||||
| <1 Day | 1-<3 Days | 3-7 Days | >7 Days | p-value | |
| Length of Stay, Days [Median (IQR)] | 8.41 (10.15) | 10.55 (10.255) | 10.27 (12.82) | 24.565 (27.62) | <0.001 |
| In-hospital Mortality [Frequency (%)] | 132 (26.04%) | 46 (31.94%) | 39 (52.00%) | 38 (51.35%) | <0.001 |
| Hyponatremia Resolution [Frequency (%)] | 215 (42.41%) | 64 (44.44%) | 39 (52.00%) | 39 (52.70%) | 0.202 |
Cox proportional hazards regression between referral timing and in-hospital mortality
Kaplan-Meier survival curve of timing of nephrology referral