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Sodium fluctuation, a novel single parameter to predict hospital mortality

  • Siyu Liang
    Affiliations
    Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China

    Eight‐year Program of Clinical Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
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  • Shi Chen
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
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  • Yuelun Zhang
    Affiliations
    Central Research Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
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  • Huijuan Zhu
    Affiliations
    Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
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  • Hui Pan
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China

    Medical Affairs, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
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Published:November 19, 2020DOI:https://doi.org/10.1016/j.ejim.2020.11.013
      Dysnatremia is the most common electrolyte disorder in hospitalized patients [1]. Dysnatremia is generally classified as hyponatremia (<135mmol/L) and hypernatremia (>145mmol/L). Many studies showed that hypernatremia and hyponatremia are independently associated with an increased risk of poor clinical outcomes in hospitalized patients [1, 2], while serum sodium levels between 135 mmol/L and 145 mmol/L are previously treated as normal. Recent studies have focused on the correlation between hospital mortality and sodium fluctuations, even within sodium reference ranges [3]. Sodium fluctuation could be a better parameter to indicate death. To our knowledge, no data were available on the accuracy and optimal cut-off point to predict hospital mortality with sodium fluctuations. We aim to explore the extent to which the sodium fluctuation during hospitalization are associated with the risk of hospital mortality and to study the value of predicting prognosis with sodium fluctuation.
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      References

        • Akirov A.
        • Diker-Cohen T.
        • Steinmetz T.
        • Amitai O.
        • Shimon I.
        Sodium levels on admission are associated with mortality risk in hospitalized patients.
        Eur J Intern Med. 2017; 46: 25-29https://doi.org/10.1016/j.ejim.2017.07.017
        • Sterns R.H.
        Disorders of plasma sodium–causes, consequences, and correction.
        N Engl J Med. 2015; 372: 55-65https://doi.org/10.1056/NEJMra1404489
        • Thongprayoon C.
        • Cheungpasitporn W.
        • Yap J.Q.
        • Qian Q.
        Increased mortality risk associated with serum sodium variations and borderline hypo- and hypernatremia in hospitalized adults.
        Nephrol Dial Transplant. 2019; https://doi.org/10.1093/ndt/gfz098
        • Lombardi G.
        • Ferraro P.M.
        • Calvaruso L.
        • Naticchia A.
        • D Alonzo S.
        • Gambaro G.
        Sodium fluctuations and mortality in a general hospitalized population.
        Kidney Blood Press Res. 2019; 44: 604-614https://doi.org/10.1159/000500916
        • Marshall D.C.
        • Salciccioli J.D.
        • Goodson R.J.
        • et al.
        The association between sodium fluctuations and mortality in surgical patients requiring intensive care.
        J Crit Care. 2017; 40: 63-68https://doi.org/10.1016/j.jcrc.2017.02.012
        • Topjian A.A.
        • Stuart A.
        • Pabalan A.A.
        • et al.
        Greater fluctuations in serum sodium levels are associated with increased mortality in children with externalized ventriculostomy drains in a PICU.
        Pediatr Crit Care Med. 2014; 15: 846-855https://doi.org/10.1097/PCC.0000000000000223
        • Sakr Y.
        • Rother S.
        • Ferreira A.M.
        • et al.
        Fluctuations in serum sodium level are associated with an increased risk of death in surgical ICU patients.
        Crit Care Med. 2013; 41: 133-142https://doi.org/10.1097/CCM.0b013e318265f576
        • Hoorn E.J.
        • Zietse R.
        Hyponatremia and mortality: moving beyond associations.
        Am J Kidney Dis. 2013; 62: 139-149https://doi.org/10.1053/j.ajkd.2012.09.019
      1. Centre for Clinical Practice at N. National Institute for Health and Clinical Excellence: Guidance. Acutely Ill Patients in Hospital: Recognition of and Response to Acute Illness in Adults in Hospital. National Institute for Health and Clinical Excellence: Guidance. London: National Institute for Health and Clinical Excellence.; 2007.

        • Smith G.B.
        • Prytherch D.R.
        • Schmidt P.E.
        • Featherstone P.I.
        • Higgins B.
        A review, and performance evaluation, of single-parameter "track and trigger" systems.
        Resuscitation. 2008; 79: 11-21https://doi.org/10.1016/j.resuscitation.2008.05.004