Serum sodium correction rate and the outcome in severe hyponatremia

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Study objective:We investigated the serum sodium correction rate on length of hospitalization and survival rate, in severe chronic hyponatremic patients at the Emergency Department (ED).Design:An observational study using clinical chart review.Setting:The ED of the University Hospital of Marcianise, Caserta, Italy with approximately 30,000 patients visits a year.Type of participants:We reviewed sixty-seven patients with severe hyponatremia subdivided in 2 subgroups: group A consisting of 35 patients with serum sodium correction rate < 0.3 mmol/h and group B consisting of 32 patients with serum sodium correction rate between < 0.5 and ≥ 0.3 mmol/h.Intervention:Emergency patients were evaluated for serum sodium correction rate for hyponatremia by clinical chart review.Measurements and main results:Severe hyponatremia was defined as a serum sodium level < 120 mmol/l. Mean serum sodium correction rate of hyponatremia was of 0.17 ± 0.09% in group A and 0.41 ± 0.05% in group B (p < 0.001 vs group A). The length of hospital stay was 10.7 ± 3.7 days for group A, and it was significantly decreased to 3.8 ± 0.4 days for group B (p < 0.005 vs group A). In addition we observed that correction rate of hyponatremia in group A was associated with a significantly lower survival rate (25%) in comparison to group B (60%) (p < 0.001 vs group A).Conclusion: We observed that serum sodium correction rate ≥ 0.3 and < 0.5 mmol/h was associated with a shorter length of hospital stay and a major survival rate.

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