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Corrigendum to: Associations of proton pump inhibitors and hospitalization due to hyponatremia: A population–based case–control study. Eur J Intern Med. 2019 Jan;59:65-69

  • Henrik Falhammar
    Correspondence
    Corresponding author: Henrik Falhammar, Department of Molecular Medicine and Surgery, Karolinska Institutet, D02:04, SE-171 76 Stockholm, Sweden.
    Affiliations
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

    Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
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  • Jonatan D. Lindh
    Affiliations
    Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
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  • Jan Calissendorff
    Affiliations
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

    Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
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  • Jakob Skov
    Affiliations
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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  • David Nathanson
    Affiliations
    Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden

    Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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  • Buster Mannheimer
    Affiliations
    Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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      The authors regret that in preparation of a new article based on the same data as in the previous published article [
      • Falhammar H
      • Lindh JD
      • Calissendorff J
      • Skov J
      • Nathanson D
      • Mannheimer B.
      Associations of proton pump inhibitors and hospitalization due to hyponatremia: A population-based case-control study.
      ], we unfortunately discovered two errors in the dataset. Some cases of hyponatremia as a secondary diagnosis had erroneously been included as primary diagnosis of hyponatremia. The corrected number of cases admitted with a primary diagnosis of hyponatremia decreased to 11,213 instead of 14,359 as reported in the article, and as a consequence the number of matched controls decreased to 44,801 instead of 57,382. The second error in the dataset was that the index date, initially labelled as the date of admission by the National Board of Health and Welfare was in fact the discharge date. After correcting for these two errors, results were overall similar, with slight differences as specified below.
      Proton pumps inhibitors and hospitalization due to hyponatremia1
      Tabled 1
      Proton pumps inhibitorsCORRECTEDCrude OR(95% CI)Proton pumps inhibitorsINCORRECTCrude OR(95% CI)Proton pumps inhibitorsCORRECTEDAdj. OR (95% CI)Proton pumps inhibitorsINCORRECTAdj. OR (95% CI)
      Omeprazole2.53 (2.40; 2.66)2.75 (2.62; 2.88)1.23 (1.15; 1.32)1.27 (1.20; 1.35)
      Pantoprazole2.06 (1.66; 2.55)2.20 (1.82; 2.65)0.98 (0.76; 1.27)1.08 (0.86; 1.34)
      Lansoprazole1.95 (1.54; 2.44)1.77 (1.47; 2.13)1.24 (0.94; 2.44)1.01 (0.81; 1.26)
      Rabeprazole4.00 (0.16; 101)2.50 (0.75; 7.49)10.53 (0.40; 276)4.26 (1.21; 13.81)
      Esomeprazole2.91 (2.55; 3.33)3.04 (2.70; 3.41)1.54 (1.31; 1.81)1.53 (1.32; 1.76)
      Any PPI2.60 (2.48; 2.73)2.80 (2.68 2.93)1.22 (1.14; 1.30)1.25 (1.18; 1.32)
      PPI, proton pumps inhibitor.
      In the updated analysis newly initiated therapy separated from ongoing therapy the associations between newly initiated treatment with lansoprazole as well as ongoing treatment with omeprazole and “any proton pump inhibitor” were now statistically significant.
      Tabled 1
      Newly initiated proton pumps inhibitorsCORRECTEDAdj. OR (95% CI)Newly initiated proton pumps inhibitorsINCORRECTAdj. OR (95% CI)Ongoingproton pumps inhibitorsCORRECTEDAdj. OR (95% CI)Ongoingproton pumps inhibitorsINCORRECTAdj. OR (95% CI)
      Omeprazole2.19 (1.90; 2.53)2.67 (2.37; 3.01)1.08 (1.00; 1.16)1.04 (0.97; 1.11)
      Pantoprazole1.89 (1.05; 3.40)2.06 (1.32; 3.19)0.81 (0.60; 1.08)0.81 (0.62; 1.05)
      Lansoprazole2.47 (1.13; 5.24)1.19 (0.72; 1.94)1.09 (0.81; 1.46)0.90 (0.70; 1.15)
      Rabeprazole**10.54 (0.40; 276)3.34 (0.84; 11.43)
      Esomeprazole2.98 (2.16; 4.12)2.89 (2.48; 3.11)1.20 (0.99; 1.45)1.12 (0.94; 1.33)
      Any PPI2.43 (2.11; 2.80)2.78 (2.48; 3.11)1.08 (1.01; 1.16)1.04 (0.98; 1.11)
      PPI, proton pumps inhibitor. *Newly initiated rabeprazole could not be analyzed since no case nor control had been newly initiated.
      The conclusion as published in the article was “With the exception of lansoprazole, this study suggests an association between any newly initiated PPI-treatment and hospitalization due to hyponatremia. Ongoing PPI use was not associated with an increased risk.”
      In the light of the revised analysis, we now conclude:
      “This study suggests an association between any newly initiated PPI-treatment and hospitalization due to hyponatremia. The excess risk largely disappeared during ongoing treatment.”
      The authors would like to apologise for any inconvenience caused.

      Reference

        • Falhammar H
        • Lindh JD
        • Calissendorff J
        • Skov J
        • Nathanson D
        • Mannheimer B.
        Associations of proton pump inhibitors and hospitalization due to hyponatremia: A population-based case-control study.
        Eur J Intern Med. 2019; 59: 65-69

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