ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P1013 | DOI: 10.1530/endoabs.63.P1013

Burden of hyponatremia on clinical outcomes in hospitalized adult medical inpatients

Alexander Kutz1,2, Fahim Ebrahimi2, Soheila Aghlmandi3, Ulrich Wagner4, Philipp Schuetz1,5, Beat Mueller1,5 & Mirjam Christ-Crain2,5


1Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland; 2Division of Endocrinology, University Hospital Basel, Basel, Switzerland; 3Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland; 4Division of Health and Social Affairs, Section Health, Swiss Federal Office for Statistics, Neuchâtel, Switzerland; 5Faculty of Medicine, University of Basel, Basel, Switzerland.


Background: Hyponatremia is the most prevalent electrolyte disorder in hospitalized adult medical patients and is associated with a significant healthcare resource burden. However, evidence remains scarce whether hyponatremia is a marker of disease severity or whether it has an independent effect on clinical outcomes.

Methods: In this nationwide cohort study, we analyzed medical inpatients with hyponatremia diagnosed between January 2009 through December 2015 using prospective administrative data. Hyponatremia patients were matched (1:1) to a non-hyponatremia cohort using propensity score matching. We used multivariate regressions models to assess differences in in-hospital mortality, intensive care unit (ICU) admission, length of hospital stay, and 30-day readmission rates.

Results: Among 2,426,722 medical inpatients, 83,871 (3.5%) were diagnosed with hyponatremia and propensity-matched with 83,871 patients without hyponatremia. We found no difference for in-hospital mortality (odds ratio [OR] 1.02, 95% confidence interval [95% CI]: 0.97–1.06, P=0.459), however a higher risk for ICU admission (OR 1.19, 95% CI: 1.15–1.22, P<0.001). The diagnosis of hyponatremia was associated with a prolonged length of hospital stay by 1.37 days (95% CI: 1.28–1.47, P<0.001). 30-day readmission rates were not significantly different between both groups (OR 1.02, 95% CI: 0.99–1.05, P=0.170).

Conclusion: Hyponatremia is an independent risk factor for increased ICU admission and length of hospital stay and therefore represents a potential target for intervention to reduce healthcare burden for a large population of hospitalized hyponatremic patients.

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