Abstract: FR-PO0586
Outcomes of Hospitalized Patients with Severe Hyponatremia: Findings from the Pilot of HypoNa-RESCUE, a Multicenter Observational Study from the United Kingdom
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 2
November 07, 2025 | 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
- Palapatti Chandran, Alexander, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, United Kingdom
- Ling Jie Yee, Amanda, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, United Kingdom
- Rafi, Samama, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, United Kingdom
- Manta, Aspasia, University of Birmingham, Birmingham, England, United Kingdom
- Manoj, Aravind, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, United Kingdom
- Iqbal, Ahmed, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, United Kingdom
- Arshad, Muhammad Fahad F, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, United Kingdom
- Kempegowda, Punith, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, United Kingdom
Background
Hyponatremia guidelines recommend limiting of sodium correction rate to prevent osmotic demyelination syndrome (ODS). However, emerging evidence suggests that ODS is extremely rare and rapid sodium correction is associated with reduced mortality. Also, there is currently no standardized surveillance system to detect ODS. So, we set up a multicenter surveillance model to explore trends in severe hyponatremia management and use data from this model to compare the length of hospital stay (LOS) between patients who underwent rapid (>10 mmol/L/24 hours) and slow correction (≤10 mmol/L/24 hours).
Methods
This multicenter observational retrospective study was conducted in the UK from January to May 2025. Patients admitted with severe hyponatremia (serum sodium <125 mmol/L) from January to December 2024 were included. Through expert consensus, we established a surveillance system called HypoNa RESCUE (Understanding Trends in Hyponatremia Management through Rapid Evaluation and Surveillance of Critical Urgencies in Endocrinology Model) to facilitate data collection. Data on demographics, precipitating factors, management, and outcomes of hyponatremia were collected. Data were analysed using SPSS and presented as appropriate in frequency or median and interquartile range [IQR].
Results
767 admissions were included in this pilot analysis with a baseline median age of 71.0 [IQR, 61.0–81.0] years and a Charlson Comorbidity index of 4.0 [3.0-5.0]. The most common aetiology for severe hyponatremia was drug-induced (21.4%). Most patients were asymptomatic (65.6%). Median sodium on admission was 121 [118-123] mmol/L, increasing to 130 [125-134] mmol/L at discharge. Hypertonic saline was used in 2.3% of admissions, and 4.7% were managed in intensive care. Brain imaging was performed in 17.9% of admissions.
45 (8.9%) patients had rapid correction, and 458 (91.1%) had slow correction. There was no significant difference in median LOS between rapid vs slow correction (7.0 [3.3-15.0] vs. 6.0 [3.0-14.0] days, p=0.496).
Conclusion
These pilot data suggests that either correction strategy did not affect LOS. Future work will explore differences in mortality and frequency of ODS, which may influence the need for prospective trials.