Prevalence, Risk Factors, and Mortality of Patients Presenting with Moderate and Severe Hyponatremia in Emergency Departments
Background. Hyponatremia is among the most common electrolyte disturbances encountered in clinical practice and is associated with a high rate of morbidity and mortality. However, there are very limited data on adult cases presenting to emergency departments with hyponatremia. Objectives. This study...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2023/9946578 |
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| author | Randa Farah Nisreen Asha Farah Mezher Saja Maaitah Fedaa Abu Al-Samen Farah Abu Abboud Salma Ajarmeh |
| author_facet | Randa Farah Nisreen Asha Farah Mezher Saja Maaitah Fedaa Abu Al-Samen Farah Abu Abboud Salma Ajarmeh |
| author_sort | Randa Farah |
| collection | DOAJ |
| description | Background. Hyponatremia is among the most common electrolyte disturbances encountered in clinical practice and is associated with a high rate of morbidity and mortality. However, there are very limited data on adult cases presenting to emergency departments with hyponatremia. Objectives. This study aimed to evaluate the frequency, clinical characteristics, and outcomes in hyponatremic patients presenting to emergency departments. Methods. This retrospective study analyzed all patients older than 18 years who visited our institution’s emergency department between October 2018 and October 2019 and has a serum sodium (Na) level <130 mmol/L. Results. Among 24,982 patients who visited the emergency department and had a documented serum sodium level, 284 were included. Patients’ median age was 67.13 ± 14.8 years. Younger patients are less likely to develop severe hyponatremia compared to older patients (adjusted odds ratio (AOR): 0.415; 95% confidence interval (CI): 0.231–0.743; p=0.003). Asymptomatic hyponatremia and gastrointestinal manifestations were the most common presenting hyponatremia symptoms (33.7% and 24.2%, respectively). Proton pump inhibitor (PPI) use, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACE/ARB) use, and spironolactone use (OR = 2.6 and 3.9, 2.3 with a p=0.02, 0.03, and 0.05, respectively) were associated with increased odds of severe hyponatremia. There is no difference in the overall mortality rate within 6 months of presentation between severe and moderate hyponatremia groups (11.1% versus 16.2%, p=0.163). Conclusion. Moderate and severe hyponatremia are not uncommon among patients presenting to emergency departments. Moderate hyponatremia can be asymptomatic with clinical significance. Older patients, use of PPI, use of ACEi/ARBs, and spironolactone use were associated with an increased risk of severe hyponatremia compared to moderate. Further prospective analysis of a larger population is needed to confirm our findings. |
| format | Article |
| id | doaj-art-2c414b6b98bb4bf58b25cae54e1d0771 |
| institution | DOAJ |
| issn | 2090-2859 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-2c414b6b98bb4bf58b25cae54e1d07712025-08-20T03:18:38ZengWileyEmergency Medicine International2090-28592023-01-01202310.1155/2023/9946578Prevalence, Risk Factors, and Mortality of Patients Presenting with Moderate and Severe Hyponatremia in Emergency DepartmentsRanda Farah0Nisreen Asha1Farah Mezher2Saja Maaitah3Fedaa Abu Al-Samen4Farah Abu Abboud5Salma Ajarmeh6Nephrology DivisionSchool of MedicineSchool of MedicineSchool of MedicineSchool of MedicineSchool of MedicinePaediatric DepartmentsBackground. Hyponatremia is among the most common electrolyte disturbances encountered in clinical practice and is associated with a high rate of morbidity and mortality. However, there are very limited data on adult cases presenting to emergency departments with hyponatremia. Objectives. This study aimed to evaluate the frequency, clinical characteristics, and outcomes in hyponatremic patients presenting to emergency departments. Methods. This retrospective study analyzed all patients older than 18 years who visited our institution’s emergency department between October 2018 and October 2019 and has a serum sodium (Na) level <130 mmol/L. Results. Among 24,982 patients who visited the emergency department and had a documented serum sodium level, 284 were included. Patients’ median age was 67.13 ± 14.8 years. Younger patients are less likely to develop severe hyponatremia compared to older patients (adjusted odds ratio (AOR): 0.415; 95% confidence interval (CI): 0.231–0.743; p=0.003). Asymptomatic hyponatremia and gastrointestinal manifestations were the most common presenting hyponatremia symptoms (33.7% and 24.2%, respectively). Proton pump inhibitor (PPI) use, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACE/ARB) use, and spironolactone use (OR = 2.6 and 3.9, 2.3 with a p=0.02, 0.03, and 0.05, respectively) were associated with increased odds of severe hyponatremia. There is no difference in the overall mortality rate within 6 months of presentation between severe and moderate hyponatremia groups (11.1% versus 16.2%, p=0.163). Conclusion. Moderate and severe hyponatremia are not uncommon among patients presenting to emergency departments. Moderate hyponatremia can be asymptomatic with clinical significance. Older patients, use of PPI, use of ACEi/ARBs, and spironolactone use were associated with an increased risk of severe hyponatremia compared to moderate. Further prospective analysis of a larger population is needed to confirm our findings.http://dx.doi.org/10.1155/2023/9946578 |
| spellingShingle | Randa Farah Nisreen Asha Farah Mezher Saja Maaitah Fedaa Abu Al-Samen Farah Abu Abboud Salma Ajarmeh Prevalence, Risk Factors, and Mortality of Patients Presenting with Moderate and Severe Hyponatremia in Emergency Departments Emergency Medicine International |
| title | Prevalence, Risk Factors, and Mortality of Patients Presenting with Moderate and Severe Hyponatremia in Emergency Departments |
| title_full | Prevalence, Risk Factors, and Mortality of Patients Presenting with Moderate and Severe Hyponatremia in Emergency Departments |
| title_fullStr | Prevalence, Risk Factors, and Mortality of Patients Presenting with Moderate and Severe Hyponatremia in Emergency Departments |
| title_full_unstemmed | Prevalence, Risk Factors, and Mortality of Patients Presenting with Moderate and Severe Hyponatremia in Emergency Departments |
| title_short | Prevalence, Risk Factors, and Mortality of Patients Presenting with Moderate and Severe Hyponatremia in Emergency Departments |
| title_sort | prevalence risk factors and mortality of patients presenting with moderate and severe hyponatremia in emergency departments |
| url | http://dx.doi.org/10.1155/2023/9946578 |
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