Editor's Pick: Retrospective Cohort Study of Long-Term Outcomes Associated with Severe Hyponatraemia
A retrospective cohort study of 202 patients reveals that severe hyponatraemia is associated with high 18-month mortality rates. The study suggests that while hypertonic saline treatment can reduce mortality, rapid correction carries risks of neurological complications.
Why it matters
The findings provide critical clinical insights for managing electrolyte abnormalities, which are common and potentially life-threatening in hospital settings.
Hyponatraemia is the most common electrolyte abnormality among hospital inpatients. This retrospective cohort study examined demographic characteristics, diagnostic investigations, clinical management, and outcomes of patients admitted with severe hyponatraemia (serum sodium ≤120 mmol/L) over an 18-month period.
A total of 202 patients were admitted with severe hyponatraemia. Hypertonic saline (HS) was administered to 25.2% of patients, and was associated with rapid correction (>8 mmol/L/24 hours) in 31.4% of recipients. The overall rate of rapid correction was 28.2%.
18-month mortality was 40.1%, rising to 50% among patients with no correction at 24 hours. Hypertonic saline use was associated with reduced mortality (27.5% versus 44.4%; p=0.03). No patients died from hyponatraemic encephalopathy, or from complications associated with rapid correction. Readmission within 6 months was common (31.2%), with recurrent hyponatraemia in 60.3% of these cases. One case of osmotic demyelination syndrome occurred in association with rapid correction.
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