The authors regret that in preparation of a new article based on the same data as in the previous published article [
[1]
], 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) | |
|---|---|---|---|---|
| Omeprazole | 2.53 (2.40; 2.66) | 2.75 (2.62; 2.88) | 1.23 (1.15; 1.32) | 1.27 (1.20; 1.35) |
| Pantoprazole | 2.06 (1.66; 2.55) | 2.20 (1.82; 2.65) | 0.98 (0.76; 1.27) | 1.08 (0.86; 1.34) |
| Lansoprazole | 1.95 (1.54; 2.44) | 1.77 (1.47; 2.13) | 1.24 (0.94; 2.44) | 1.01 (0.81; 1.26) |
| Rabeprazole | 4.00 (0.16; 101) | 2.50 (0.75; 7.49) | 10.53 (0.40; 276) | 4.26 (1.21; 13.81) |
| Esomeprazole | 2.91 (2.55; 3.33) | 3.04 (2.70; 3.41) | 1.54 (1.31; 1.81) | 1.53 (1.32; 1.76) |
| Any PPI | 2.60 (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) | |
|---|---|---|---|---|
| Omeprazole | 2.19 (1.90; 2.53) | 2.67 (2.37; 3.01) | 1.08 (1.00; 1.16) | 1.04 (0.97; 1.11) |
| Pantoprazole | 1.89 (1.05; 3.40) | 2.06 (1.32; 3.19) | 0.81 (0.60; 1.08) | 0.81 (0.62; 1.05) |
| Lansoprazole | 2.47 (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) |
| Esomeprazole | 2.98 (2.16; 4.12) | 2.89 (2.48; 3.11) | 1.20 (0.99; 1.45) | 1.12 (0.94; 1.33) |
| Any PPI | 2.43 (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
- Associations of proton pump inhibitors and hospitalization due to hyponatremia: A population-based case-control study.Eur J Intern Med. 2019; 59: 65-69
Article info
Publication history
Published online: June 23, 2021
Accepted:
May 15,
2021
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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- Associations of proton pump inhibitors and hospitalization due to hyponatremia: A population–based case–control studyEuropean Journal of Internal MedicineVol. 59
- PreviewSmall observational studies and case reports have indicated that proton pump inhibitors (PPIs) may cause hyponatremia. Whether there is a difference between the individual PPIs is yet unknown. Since PPIs are one of the most commonly prescribed groups of drugs, even a rare adverse reaction may have large implications. The objective was to study the association between PPIs and hospitalization due to hyponatremia.
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