Prognosis of Cancer Patients with Severe Hyponatremia in the Emergency Department: A Retrospective Study from the National Cancer Center of China.

IF 2.8 4区医学 Q2 ONCOLOGY

Current oncology Pub Date : 2025-04-23 DOI:10.3390/curroncol32050245

Qinglong Jiang, Xi Zhang, Chao Wang, Rong Qin, Rui Sun, Shengling Qin, Cong Zhao, Zhiyong Li, Wenjie Zhu, Minghua Cong

{"title":"Prognosis of Cancer Patients with Severe Hyponatremia in the Emergency Department: A Retrospective Study from the National Cancer Center of China.","authors":"Qinglong Jiang, Xi Zhang, Chao Wang, Rong Qin, Rui Sun, Shengling Qin, Cong Zhao, Zhiyong Li, Wenjie Zhu, Minghua Cong","doi":"10.3390/curroncol32050245","DOIUrl":null,"url":null,"abstract":"Aim: The aim of this study was to analyze the clinical characteristics and prognostic factors of profound hyponatremia in solid cancer patients admitted to the oncologic emergency department.Methods: We gathered data retrospectively from cancer patients who visited the emergency department of the National Cancer Center of China between October 2019 and February 2023 with a serum sodium (Na) level of less than 125 mmol/L. The demographic and clinical characteristics, medical history, admission symptoms, laboratory parameters, and outcomes of the patients were recorded.Results: This study comprised 307 patients with severe hyponatremia in total. With 39.4% of all tumors being lung cancer (n = 121), nausea and vomiting were the most common admission symptoms for patients with severe hyponatremia. The 30-day mortality rate of profound hyponatremia cancer patients in the emergency department was 13.4%. The albumin level (p < 0.001), the hemoglobin level (p = 0.033), the TNM stage (p = 0.004), the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) score (p < 0.001), hypocalcemia (p = 0.006), renal insufficiency (p = 0.035), and the efficacy of sodium supplementation (p = 0.006) were significantly associated with 30-day mortality. Binary logistic regression analysis showed that a lower albumin level (OR 0.924, 95% CI 0.861-0.991, p = 0.028) and higher ECOG score (OR 8.443, 95% CI 3.568-19.976, p < 0.001) were independent risk factors for 30-day mortality. The overall survival of emergency cancer patients with severe hyponatremia was also examined. The results of the COX regression analysis demonstrated that the efficacy of sodium supplementation (OR = 2.643, 95% CI 1.593-4.386, p < 0.001), a low albumin level (OR = 0.654, 95% CI 0.463-0.923, p = 0.016), the TNM stage (OR = 4.606, 95% CI 2.846-7.455), and a higher ECOG score (OR = 1.738, 95% CI 1.292-2.338, p < 0.001) were independent risk factors for overall survival.Conclusions: The clinical manifestations of severe hyponatremia in emergency cancer patients are varied. Hypoalbuminemia and a higher ECOG score are independent risk factors for 30-day mortality and overall survival. Severe hyponatremia patients with a high ECOG score and/or a low albumin level should be monitored and followed more closely.","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"32 5","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110312/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/curroncol32050245","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aim: The aim of this study was to analyze the clinical characteristics and prognostic factors of profound hyponatremia in solid cancer patients admitted to the oncologic emergency department.

Methods: We gathered data retrospectively from cancer patients who visited the emergency department of the National Cancer Center of China between October 2019 and February 2023 with a serum sodium (Na) level of less than 125 mmol/L. The demographic and clinical characteristics, medical history, admission symptoms, laboratory parameters, and outcomes of the patients were recorded.

Results: This study comprised 307 patients with severe hyponatremia in total. With 39.4% of all tumors being lung cancer (n = 121), nausea and vomiting were the most common admission symptoms for patients with severe hyponatremia. The 30-day mortality rate of profound hyponatremia cancer patients in the emergency department was 13.4%. The albumin level (p < 0.001), the hemoglobin level (p = 0.033), the TNM stage (p = 0.004), the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) score (p < 0.001), hypocalcemia (p = 0.006), renal insufficiency (p = 0.035), and the efficacy of sodium supplementation (p = 0.006) were significantly associated with 30-day mortality. Binary logistic regression analysis showed that a lower albumin level (OR 0.924, 95% CI 0.861-0.991, p = 0.028) and higher ECOG score (OR 8.443, 95% CI 3.568-19.976, p < 0.001) were independent risk factors for 30-day mortality. The overall survival of emergency cancer patients with severe hyponatremia was also examined. The results of the COX regression analysis demonstrated that the efficacy of sodium supplementation (OR = 2.643, 95% CI 1.593-4.386, p < 0.001), a low albumin level (OR = 0.654, 95% CI 0.463-0.923, p = 0.016), the TNM stage (OR = 4.606, 95% CI 2.846-7.455), and a higher ECOG score (OR = 1.738, 95% CI 1.292-2.338, p < 0.001) were independent risk factors for overall survival.

Conclusions: The clinical manifestations of severe hyponatremia in emergency cancer patients are varied. Hypoalbuminemia and a higher ECOG score are independent risk factors for 30-day mortality and overall survival. Severe hyponatremia patients with a high ECOG score and/or a low albumin level should be monitored and followed more closely.

查看原文本刊更多论文

急诊科癌症合并严重低钠血症患者的预后：来自中国国家癌症中心的回顾性研究

目的：分析肿瘤急诊科实体癌患者重度低钠血症的临床特点及影响预后的因素。方法：回顾性收集2019年10月至2023年2月在中国国家癌症中心急诊科就诊的血清钠（Na）水平小于125 mmol/L的癌症患者的资料。记录患者的人口学和临床特征、病史、入院症状、实验室参数和转归。结果：本研究共纳入307例重度低钠血症患者。39.4%的肿瘤为肺癌（n = 121），恶心和呕吐是严重低钠血症患者最常见的入院症状。急诊科重度低钠血症癌患者30天死亡率为13.4%。白蛋白水平（p < 0.001）、血红蛋白水平（p = 0.033）、TNM分期（p = 0.004）、东部肿瘤合作组表现状态（ECOG-PS）评分（p < 0.001）、低钙血症（p = 0.006）、肾功能不全（p = 0.035）、补钠疗效（p = 0.006）与30天死亡率显著相关。二元logistic回归分析显示，较低的白蛋白水平（OR 0.924, 95% CI 0.861-0.991, p = 0.028）和较高的ECOG评分（OR 8.443, 95% CI 3.568-19.976, p < 0.001）是30天死亡率的独立危险因素。对急诊癌症合并严重低钠血症患者的总生存率也进行了研究。COX回归分析结果显示，钠补充的有效性（OR = 2.643, 95% CI 1.593-4.386, p < 0.001）、低白蛋白水平（OR = 0.654, 95% CI 0.463-0.923, p = 0.016）、TNM分期（OR = 4.606, 95% CI 2.846-7.455）和较高的ECOG评分（OR = 1.738, 95% CI 1.292-2.338, p < 0.001）是影响总生存的独立危险因素。结论：恶性肿瘤急诊患者重度低钠血症的临床表现多种多样。低白蛋白血症和较高的ECOG评分是30天死亡率和总生存率的独立危险因素。ECOG评分高和/或白蛋白水平低的严重低钠血症患者应进行更密切的监测和随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current oncology ONCOLOGY-

CiteScore

3.30

自引率

7.70%

发文量

664

审稿时长

1 months

期刊介绍： Current Oncology is a peer-reviewed, Canadian-based and internationally respected journal. Current Oncology represents a multidisciplinary medium encompassing health care workers in the field of cancer therapy in Canada to report upon and to review progress in the management of this disease. We encourage submissions from all fields of cancer medicine, including radiation oncology, surgical oncology, medical oncology, pediatric oncology, pathology, and cancer rehabilitation and survivorship. Articles published in the journal typically contain information that is relevant directly to clinical oncology practice, and have clear potential for application to the current or future practice of cancer medicine.