Systemic and iatrogenic factors contribute to the development of severe hypernatraemia in vulnerable inpatients
Main finding · All-cause in-hospital mortalityResult — go to the resultOdds ratio 0.15 95% CI 0.04–0.54Authors' conclusion
Mortality was high and loss of independence in survivors common. To potentially improve outcomes, hypernatraemia-specific guidelines should be formulated and efforts made to reduce system and iatrogenic factors.
Study context
- Population
- Inpatients with severe hypernatraemia (sodium ≥155 mmol/L) at any time during admission, tertiary hospital, Melbourne, Australia, 1 January–31 December 2019 (pre-COVID19)
- Participants
- 101 inpatients
- Exposure
- Community-acquired vs hospital-acquired severe hypernatraemia
- Community-acquiredn = 64
- Hospital-acquiredn = 37reference
- Outcome
- All-cause in-hospital mortality
Methodological detailsobservational, single tertiary hospital
- Observational
- Single tertiary hospital
Main finding
As reported in the abstract
Odds ratio
0.15
95% CI 0.04–0.54
P = 0.003
Communityvs Hospital
OR 0.15 (95% CI 0.04–0.54); P = 0.003
- In-hospital mortality, all patients
- 38%
Observational data: associations, not effects.
Further findings
Dementia prevalence · higher in Community
P = 0.001
Infection as precipitant
Median
| Outcome | Community-acquired | Hospital-acquired |
|---|---|---|
| Charlson Comorbidity Index | 6 (IQR 5–8) | 5 (IQR 4–7) |
- Iatrogenic factors in hospital-acquired cases
- 57% · 21 of 37
Cumulative mortality · 1 month after discharge
- Cumulative mortality by 1 month after discharge
- 65%
- Only a minor further increase at 6 and 12 months
Active sodium-directed treatment
- All cases receiving active sodium-directed treatment
- 55%
- Time to start treatment did not affect outcomes
Infection as precipitant
- Infection was the most common precipitant
Discharge to residential care among survivors previously living independently
- Survivors previously living independently who required residential care
- 32%
Original publication
Systemic and iatrogenic factors contribute to the development of severe hypernatraemia in vulnerable inpatients. Clin Endocrinol (Oxf). Published 8 October 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →