Clinical characteristics and prognosis in patients with hyponatremic encephalopathy
Abstract
Introduction: Hyponatremic encephalopathy mortality rate reaches about 50% in some special groups of patients (pediatric, child-bearing age women, etc.). However, morbimortality seems to be much lower in men and elderly population. Methods: A retrospective and observational study on patients with hyponatremic encephalopathy diagnosis was carried out. Results: 47 patients with hyponatremic encephalopathy diagnosis were identified. It was an elderly population (age 69±15 years) with women prevalence. In-hospital mortality was 19.1% and neurological aftermaths in the survivors were 27%. Charlson score and delay to initiate treatment were associated to larger in-hospital mortality. Conclusion: mortality rate observed in our population is less than the one observed in other cohorts, probably due to the fact of being a low risk population. In a logistic regression model, delay in initiating an adequate treatment is associated to larger mortality rate in the studied population.
References
Hoor EJ, Lindemans J, Zietse R. Development of severe hyponatraemia in hospitalized patients: treatment-related risk factors and inadequate management. Nephrol Dial Transplant 2006; 21:70-6.
Wald R, Jaber BL, Price LL. Impact of HospitalAssociated Hyponatremia on Selected Outcomes. Arch Intern Med 2010; 170:294-302.
Hoorn EJ, Geary D, Robb M, Halperin ML, et al. Acute hiponatremia related to intravenous fluid administration in hospitalized children: an observational study. Pediatrics 2004; 113:1279-84.
Zilberberg MD, Exuzides A, Spalding J. Epidemiology, clinical and economic outcomes of admission hiponatremia among hospitalized patients. Curr Med Res Opin 2008;24(6):1601–1608.
Waikar SS, Mount DB, Curhan GC. Mortality after Hospitalization with Mild, Moderate, and Severe Hyponatremia. Am J Med 2009; 122:857-65.
Arieff AI, Ayus JC, Fraser CL. Hyponatraemia and death or permanent brain damage in healthychildren. BMJ 1992; 304:1218-22.
Ayus JC; Wheeler JM; Arieff AI. Postoperative hyponatremic encephalopathy in menstruant women. Ann Intern Med 1992; 117:891-7.
Arieff AI. Hyponatremia, convulsions, respiratory arrest, and permanent brain damage after elective surgery in healthy women. N Engl J Med 1986;314:1529-35.
Ayus JC, Arieff AI. Chronic hyponatremic encephalopathy in postmenopausal women: association of therapies with morbidity and mortality. JAMA 1999; 281:2299-304.
Hoorn EJ, Lindemans J, Zietse R. Development of severe hyponatraemia in hospitalized patients: treatment-related risk factors and inadequate management. Nephrol Dial Transplant 2006; 21:70-6.
Huda MS, Boyd A, Skagen K et al. Investigation and management of severe hyponatraemia in a hospital setting. Postgrad Med J 2006; 82:216-9.
Nzerue CM, Baffoe-Bonnie H, You W, S. Predictors of outcome in hospitalized patients with severe hyponatremia. J Natl Med Assoc 2003; 95:335-43.
Ayus JC, Caputo D, Bazerque F, et al. Treatment of hyponatremic encephalopathy with a 3% sodium chloride protocol: a case series. Am J Kidney Dis 2015; 65:435-42.
Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Developmentand validation. J Chronic Dis 1987; 40:373-83.