Abstract 15818: Association Between Hyponatremia on Admission and Re-Hospitalization in Patients With Acute Decompensated Heart Failure
Background: Although hyponatremia during hospitalization for acute decompensated heart failure (ADHF) has been reported to relate with poor prognosis, few studies have examined the impact of hyponatremia at admission on clinical events including all-cause death and re-hospitalization in patients with ADHF. Thus, we investigated the association between hyponatremia at admission and long-term incidence of clinical events.
Methods: A cohort of 1684 patients consecutively admitted to the cardiac intensive-care unit from 2007 to 2011 was studied. Among them, patients admitted due to ADHF (defined according to the current guideline) are enrolled. Patients with other life-threatening condition such as neoplasm and shock were excluded. Baseline data were collected at the time of patients’ arrival to the hospital. All eligible patients were categorized according to the sodium levels of <135 mmol/L (Hyponatremia) or ≥135 mmol/L at admission. The risk of hyponatremia for clinical events, composite of all-cause deaths and re-hospitalizations was assessed by multivariable Cox proportional model including other independent variables which showed P<0.1 in univariable analyses.
Results: Finally, 435 patients were assessed. At a median follow-up of 1.8 years, there were 284 clinical events (65.3%). Hyponatremia was observed in 78 patients (17.9%). Cumulative survivals were significantly different between two groups (Figure). In the multivariable model including other independent variables (age, ischemic heart disease, diabetes mellitus, heart rate, hemoglobin, C-reactive protein, potassium levels, and estimated glomerular filtration rate), compared with patients with sodium level of ≥135 mmol/L, patients with sodium level of <135 mmol/L showed a greater risk of clinical events (hazard ratio, 1.58; P=0.008).
Conclusion: In patients admitted with ADHF, hyponatremia at admission was associated with increased re-hospitalization rate and mortality.
- © 2013 by American Heart Association, Inc.