Hyponatremia and short-term outcomes in patients with acute pulmonary embolism

Détails

ID Serval
serval:BIB_BE03FE2D70A1
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Institution
Titre
Hyponatremia and short-term outcomes in patients with acute pulmonary embolism
Titre de la conférence
33rd Annual Meeting of the Society of General Internal Medicine
Auteur(s)
Mean Marie, Aujesky Drahomir, Scherz Nathalie, Labarere Jose
Adresse
Minneapolis (MN) - United States, 18 April - 1 May 2010
ISBN
0884-8734
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
25
Série
Journal of General Internal Medicine
Pages
299
Langue
anglais
Notes
Meeting Abstract
Résumé
BACKGROUND:
Hyponatremia, a marker of neurohormonal activation, is associated with poor outcomes in acute cardiorespiratory diseases such as myocardial infarction, right and left ventricular heart failure, and pneumonia. The prognostic value of hyponatremia in patients with acute pulmonary embolism (PE) is unknown. We sought to assess whether hyponatremia at presentation was
associated with mortality and hospital readmission in patients hospitalized with PE.
METHODS:
We studied patient discharges with a primary diagnosis of PE from 185 acute care hospitals in Pennsylvania (1/2000-11/2002). We defined hyponatremia as a serum sodium level ≤135 mmol/l, measured at the time of patient presentation. The study outcomes were 30-day all-cause mortality and hospital readmission. We used random-intercept logistic regression to examine the association between hyponatremia and mortality. We adjusted for baseline patient (race, insurance, severity of illness using the Pulmonary Embolism Severity Index) and hospital characteristics (region, hospital size and teaching status). We used the same approach to
examine the association between hyponatremia and readmission among patients who were discharged alive.
RESULTS:
Among 13,728 patient discharges with PE, 2907 (21.1%) had hyponatremia at the time of presentation. Patients with hyponatremia were older (P<0.001) and more likely to have a history of cancer (P<0.001), heart failure (P<0.001), or chronic lung disease (P=0.002) than patients without hyponatremia. Patients with hyponatremia had a higher unadjusted cumulative 30-day mortality (15.2% vs 8.0%;P<0.001) and readmission rate (15.9% vs 11.8%; P< 0.001) than patients without hyponatremia (Figure). After adjustment for race, insurance, severity of illness, and hospital factors, hyponatremia was associated with a significantly greater odds of
death (OR 1.71, 95% CI: 1.50-1.95) and hospital readmission (OR 1.29, 95% CI: 1.14-1.46).
CONCLUSIONS:
In this large, statewide sample of unselected patients with acute PE, hyponatremia was relatively common and was an independent predictor of short-term mortality and hospital readmission. Given that sodium is a low-cost, easily available laboratory parameter, it may be potentially useful in risk-stratifying patients with PE.
Web of science
Création de la notice
01/09/2010 14:50
Dernière modification de la notice
16/10/2019 10:52
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