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Diagnostic Workup and Outcome in Patients with Profound Hyponatremia

Hyponatremia is the most common electrolyte disorder. A proper diagnosis is important for its successful management, especially in profound hyponatremia. The European hyponatremia guidelines point at sodium and osmolality measurement in plasma and urine, and the clinical evaluation of volume status...

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Autores principales: Isaak, Johann, Boesing, Maria, Potasso, Laura, Lenherr, Christoph, Luethi-Corridori, Giorgia, Leuppi, Joerg D., Leuppi-Taegtmeyer, Anne B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219478/
https://www.ncbi.nlm.nih.gov/pubmed/37240673
http://dx.doi.org/10.3390/jcm12103567
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author Isaak, Johann
Boesing, Maria
Potasso, Laura
Lenherr, Christoph
Luethi-Corridori, Giorgia
Leuppi, Joerg D.
Leuppi-Taegtmeyer, Anne B.
author_facet Isaak, Johann
Boesing, Maria
Potasso, Laura
Lenherr, Christoph
Luethi-Corridori, Giorgia
Leuppi, Joerg D.
Leuppi-Taegtmeyer, Anne B.
author_sort Isaak, Johann
collection PubMed
description Hyponatremia is the most common electrolyte disorder. A proper diagnosis is important for its successful management, especially in profound hyponatremia. The European hyponatremia guidelines point at sodium and osmolality measurement in plasma and urine, and the clinical evaluation of volume status as the minimum diagnostic workup for the diagnosis of hyponatremia. We aimed to determine compliance with guidelines and to investigate possible associations with patient outcomes. In this retrospective study, we analysed the management of 263 patients hospitalised with profound hyponatremia at a Swiss teaching hospital between October 2019 and March 2021. We compared patients with a complete minimum diagnostic workup (D-Group) to patients without (N-Group). A minimum diagnostic workup was performed in 65.5% of patients and 13.7% did not receive any treatment for hyponatremia or an underlying cause. The twelve-month survival did not show statistically significant differences between the groups (HR 1.1, 95%-CI: 0.58–2.12, p-value 0.680). The chance of receiving treatment for hyponatremia was higher in the D-group vs. N-Group (91.9% vs. 75.8%, p-value < 0.001). A multivariate analysis showed significantly better survival for treated patients compared to not treated (HR 0.37, 95%-CI: 0.17–0.78, p-value 0.009). More efforts should be made to ensure treatment of profound hyponatremia in hospitalised patients.
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spelling pubmed-102194782023-05-27 Diagnostic Workup and Outcome in Patients with Profound Hyponatremia Isaak, Johann Boesing, Maria Potasso, Laura Lenherr, Christoph Luethi-Corridori, Giorgia Leuppi, Joerg D. Leuppi-Taegtmeyer, Anne B. J Clin Med Article Hyponatremia is the most common electrolyte disorder. A proper diagnosis is important for its successful management, especially in profound hyponatremia. The European hyponatremia guidelines point at sodium and osmolality measurement in plasma and urine, and the clinical evaluation of volume status as the minimum diagnostic workup for the diagnosis of hyponatremia. We aimed to determine compliance with guidelines and to investigate possible associations with patient outcomes. In this retrospective study, we analysed the management of 263 patients hospitalised with profound hyponatremia at a Swiss teaching hospital between October 2019 and March 2021. We compared patients with a complete minimum diagnostic workup (D-Group) to patients without (N-Group). A minimum diagnostic workup was performed in 65.5% of patients and 13.7% did not receive any treatment for hyponatremia or an underlying cause. The twelve-month survival did not show statistically significant differences between the groups (HR 1.1, 95%-CI: 0.58–2.12, p-value 0.680). The chance of receiving treatment for hyponatremia was higher in the D-group vs. N-Group (91.9% vs. 75.8%, p-value < 0.001). A multivariate analysis showed significantly better survival for treated patients compared to not treated (HR 0.37, 95%-CI: 0.17–0.78, p-value 0.009). More efforts should be made to ensure treatment of profound hyponatremia in hospitalised patients. MDPI 2023-05-19 /pmc/articles/PMC10219478/ /pubmed/37240673 http://dx.doi.org/10.3390/jcm12103567 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Isaak, Johann
Boesing, Maria
Potasso, Laura
Lenherr, Christoph
Luethi-Corridori, Giorgia
Leuppi, Joerg D.
Leuppi-Taegtmeyer, Anne B.
Diagnostic Workup and Outcome in Patients with Profound Hyponatremia
title Diagnostic Workup and Outcome in Patients with Profound Hyponatremia
title_full Diagnostic Workup and Outcome in Patients with Profound Hyponatremia
title_fullStr Diagnostic Workup and Outcome in Patients with Profound Hyponatremia
title_full_unstemmed Diagnostic Workup and Outcome in Patients with Profound Hyponatremia
title_short Diagnostic Workup and Outcome in Patients with Profound Hyponatremia
title_sort diagnostic workup and outcome in patients with profound hyponatremia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219478/
https://www.ncbi.nlm.nih.gov/pubmed/37240673
http://dx.doi.org/10.3390/jcm12103567
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