A retrospective cohort study on the clinical outcomes of patients admitted to intensive care units with dysnatremia.

Autor: Ng PY; Critical Care Medicine Unit, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.; Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China., Cheung RYT; Critical Care Medicine Unit, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China., Ip A; Critical Care Medicine Unit, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China., Chan WM; Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China., Sin WC; Critical Care Medicine Unit, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.; Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China., Yap DY; Department of Medicine, The University of Hong Kong, Hong Kong SAR, China. desmondy@hku.hk.; Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 301, 3/F New Clinical Building, 102 Pokfulam Road, Hong Kong SAR, China. desmondy@hku.hk.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 Dec 01; Vol. 13 (1), pp. 21236. Date of Electronic Publication: 2023 Dec 01.
DOI: 10.1038/s41598-023-48399-5
Abstrakt: With evolving patient characteristics and patterns of ICU utilization, the impact of dysnatremias on patient outcomes and healthcare costs in the present era have not been well studied. Patients ≥ 18 years admitted to the ICUs in public hospitals in Hong Kong between January 2010 and June 2022 and had at least one serum sodium measurement obtained within 24 h prior to or following ICU admission were stratified into normonatremic (135-145 mmol/L), hyponatremic (< 135 mmol/L) and hypernatremic (> 145 mmol/L) groups. A total of 162,026 patients were included-9098 (5.6%), 40,533 (25.0%) and 112,395 (69.4%) patients were hypernatremic, hyponatremic and normonatremic at the time of ICU admission, respectively. The odds of patients with hypernatremia and hyponatremia dying in the ICU were 27% and 14% higher (aOR 1.27, 95% CI 1.19-1.36 and aOR 1.14, 95% CI 1.08-1.19, respectively; P < 0.001 for both), and 52% and 21% higher for dying in the hospital (aOR 1.52, 95% CI 1.43-1.62 and aOR 1.21, 95% CI 1.17-1.26, respectively; P < 0.001 for both] compared with those with normonatremia. Patients with dysnatremia also had longer ICU length of stay (LOS), hospital LOS, and higher healthcare costs than the normonatremic group. Dysnatremias at ICU admission were associated with increased ICU and in-hospital mortality and overall healthcare burden.
(© 2023. The Author(s).)
Databáze: MEDLINE
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