The combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremia
BACKGROUND: Hyponatremia is common in hospitalized patients with heart failure (HF) and predicts a poor prognosis after discharge. In general, hyponatremia can be divided into two types: dilutional or depletional. OBJECTIVE: Assess the impact of hyponatremia type on short-term outcomes. DESIGN: Retr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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King Faisal Specialist Hospital and Research Centre
2023-01-01
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| Series: | Annals of Saudi Medicine |
| Online Access: | http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.17 |
| _version_ | 1811171932452683776 |
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| author | Jiahuan Rao Yusheng Ma Jieni Long Yan Tu Zhigang Guo |
| author_facet | Jiahuan Rao Yusheng Ma Jieni Long Yan Tu Zhigang Guo |
| author_sort | Jiahuan Rao |
| collection | DOAJ |
| description | BACKGROUND: Hyponatremia is common in hospitalized patients with heart failure (HF) and predicts a poor prognosis after discharge. In general, hyponatremia can be divided into two types: dilutional or depletional. OBJECTIVE: Assess the impact of hyponatremia type on short-term outcomes. DESIGN: Retrospective cohort SETTINGS: Single center in China PATIENTS AND METHODS: We sorted patients by hyponatremia into two types: dilutional hyponatremia (DiH, with hematocrit <35%) and depletional hyponatremia (DeH, with hematocrit ≥35%). The Kaplan-Meier method and Cox regression analysis were used to identify the impact of hyponatremia types on the risk for 90-day readmission and death. MAIN OUTCOME MEASURES: 90-day readmission and death combined. SAMPLE SIZE: 1770 patients. RESULTS: Hyponatremia was present in 324/1770 patients with 182 cases classified as DiH versus 142 as DeH. Kaplan-Meier analyses showed a higher incidence of poor short-term outcomes in hyponatremia compared with normonatremia (log-rank P<.001), and the risk was higher in DiH than DeH although the difference was not statistically significant (log-rank P=.656). Multivariate Cox regression analyses showed that only DiH was independently associated with short-term outcomes (HR=1.34, 95%CI: 1.02-1.77, P=.038), but not DeH (HR=1.32, 95%CI: 0.97-1.80, P=.081). Analysis of the secondary endpoints showed that DiH increased the risk of readmission but not death (HR=1.36, P=.035 for readmission; HR=1.13, P=.831 for all-cause death). CONCLUSIONS: Low hematocrit, rather than high hematocrit, with hyponatremia was associated with a risk of 90-day readmission in patients with HF. LIMITATIONS: Single center, nonrandomized. CONFLICT OF INTEREST: None. |
| first_indexed | 2024-04-10T17:22:36Z |
| format | Article |
| id | doaj.art-4b02c85911f74193b6d8d29c54dee18e |
| institution | Directory Open Access Journal |
| issn | 0256-4947 0975-4466 |
| language | English |
| last_indexed | 2024-04-10T17:22:36Z |
| publishDate | 2023-01-01 |
| publisher | King Faisal Specialist Hospital and Research Centre |
| record_format | Article |
| series | Annals of Saudi Medicine |
| spelling | doaj.art-4b02c85911f74193b6d8d29c54dee18e2023-02-05T08:01:48ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662023-01-01431172410.5144/0256-4947.2023.17The combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremiaJiahuan Rao0Yusheng Ma1Jieni Long2Yan Tu3Zhigang Guo4From the Department of Cardiology, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaFrom the Department of Cardiology, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaFrom the Department of Cardiology, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaFrom the Department of Cardiology, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaFrom the Department of Cardiology, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaBACKGROUND: Hyponatremia is common in hospitalized patients with heart failure (HF) and predicts a poor prognosis after discharge. In general, hyponatremia can be divided into two types: dilutional or depletional. OBJECTIVE: Assess the impact of hyponatremia type on short-term outcomes. DESIGN: Retrospective cohort SETTINGS: Single center in China PATIENTS AND METHODS: We sorted patients by hyponatremia into two types: dilutional hyponatremia (DiH, with hematocrit <35%) and depletional hyponatremia (DeH, with hematocrit ≥35%). The Kaplan-Meier method and Cox regression analysis were used to identify the impact of hyponatremia types on the risk for 90-day readmission and death. MAIN OUTCOME MEASURES: 90-day readmission and death combined. SAMPLE SIZE: 1770 patients. RESULTS: Hyponatremia was present in 324/1770 patients with 182 cases classified as DiH versus 142 as DeH. Kaplan-Meier analyses showed a higher incidence of poor short-term outcomes in hyponatremia compared with normonatremia (log-rank P<.001), and the risk was higher in DiH than DeH although the difference was not statistically significant (log-rank P=.656). Multivariate Cox regression analyses showed that only DiH was independently associated with short-term outcomes (HR=1.34, 95%CI: 1.02-1.77, P=.038), but not DeH (HR=1.32, 95%CI: 0.97-1.80, P=.081). Analysis of the secondary endpoints showed that DiH increased the risk of readmission but not death (HR=1.36, P=.035 for readmission; HR=1.13, P=.831 for all-cause death). CONCLUSIONS: Low hematocrit, rather than high hematocrit, with hyponatremia was associated with a risk of 90-day readmission in patients with HF. LIMITATIONS: Single center, nonrandomized. CONFLICT OF INTEREST: None.http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.17 |
| spellingShingle | Jiahuan Rao Yusheng Ma Jieni Long Yan Tu Zhigang Guo The combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremia Annals of Saudi Medicine |
| title | The combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremia |
| title_full | The combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremia |
| title_fullStr | The combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremia |
| title_full_unstemmed | The combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremia |
| title_short | The combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremia |
| title_sort | combined impact of hyponatremia and hematocrit on the risk for 90 day readmission and death in patients with heart failure dilutional hyponatremia versus depletional hyponatremia |
| url | http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.17 |
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