Jiahuan Rao, Yusheng Ma, Jieni Long, Yan Tu, Zhigang Guo
{"title":"低钠血症和红细胞压积对心力衰竭患者90天再入院和死亡风险的综合影响:稀释性低钠血症vs消耗性低钠血症","authors":"Jiahuan Rao, Yusheng Ma, Jieni Long, Yan Tu, Zhigang Guo","doi":"10.5144/0256-4947.2023.17","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>Assess the impact of hyponatremia type on short-term outcomes.</p><p><strong>Design: </strong>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.</p><p><strong>Main outcome measures: </strong>90-day readmission and death combined.</p><p><strong>Sample size: </strong>1770 patients.</p><p><strong>Results: </strong>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 <i>P</i><.001), and the risk was higher in DiH than DeH although the difference was not statistically significant (log-rank <i>P</i>=.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, <i>P</i>=.038), but not DeH (HR=1.32, 95%CI: 0.97-1.80, <i>P</i>=.081). Analysis of the secondary endpoints showed that DiH increased the risk of readmission but not death (HR=1.36, <i>P</i>=.035 for readmission; HR=1.13, <i>P</i>=.831 for all-cause death).</p><p><strong>Conclusions: </strong>Low hematocrit, rather than high hematocrit, with hyponatremia was associated with a risk of 90-day readmission in patients with HF.</p><p><strong>Limitations: </strong>Single center, nonrandomized.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/f5/0256-4947.2023.17.PMC9899337.pdf","citationCount":"0","resultStr":"{\"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.\",\"authors\":\"Jiahuan Rao, Yusheng Ma, Jieni Long, Yan Tu, Zhigang Guo\",\"doi\":\"10.5144/0256-4947.2023.17\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>Assess the impact of hyponatremia type on short-term outcomes.</p><p><strong>Design: </strong>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.</p><p><strong>Main outcome measures: </strong>90-day readmission and death combined.</p><p><strong>Sample size: </strong>1770 patients.</p><p><strong>Results: </strong>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 <i>P</i><.001), and the risk was higher in DiH than DeH although the difference was not statistically significant (log-rank <i>P</i>=.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, <i>P</i>=.038), but not DeH (HR=1.32, 95%CI: 0.97-1.80, <i>P</i>=.081). 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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: 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.
期刊介绍：
The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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