Pfortmueller Carmen A, Funk Georg-Christian, Leichtle Alexander B, Fiedler Georg M, Schwarz Christoph, Exadaktylos Aristomenis K, Lindner Gregor
Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.
Department of Respiratory and Critical Care Medicine, Otto Wagner Spital Vienna and Ludwig-Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria.
PLoS One. 2014 Mar 20;9(3):e92150. doi: 10.1371/journal.pone.0092150. eCollection 2014.
Heat periods during recent years were associated with excess hospitalization and mortality rates, especially in the elderly. We intended to study whether prolonged warmth/heat periods are associated with an increased prevalence of disorders of serum sodium and potassium and an increased hospital mortality.
In this cross-sectional analysis all patients admitted to the Department of Emergency Medicine of a large tertiary care facility between January 2009 and December 2010 with measurements of serum sodium were included. Demographic data along with detailed data on diuretic medication, length of hospital stay and hospital mortality were obtained for all patients. Data on daily temperatures (maximum, mean, minimum) and humidity were retrieved by Meteo Swiss.
A total of 22.239 patients were included in the study. 5 periods with a temperature exceeding 25 °C for 3 to 5 days were noticed and 2 periods with temperatures exceeding 25 °C for more than 5 days were noted. Additionally, 2 periods with 3 to 5 days with daily temperatures exceeding 30 °C were noted during the study period. We found a significantly increased prevalence of hyponatremia during heat periods. However, in the Cox regression analysis, prolonged heat was not associated with the prevalence of disorders of serum sodium or potassium. Admission during a heat period was an independent predictor for hospital mortality.
Although we found an increased prevalence of hyponatremia during heat periods, no convincing connection could be found for hypernatremia or disorders of serum potassium.
近年来的炎热时期与住院率和死亡率过高有关，尤其是在老年人中。我们旨在研究长时间的温暖/炎热时期是否与血清钠和钾紊乱的患病率增加以及医院死亡率增加有关。
在这项横断面分析中，纳入了2009年1月至2010年12月期间入住一家大型三级医疗设施急诊科且测量了血清钠的所有患者。获取了所有患者的人口统计学数据以及有关利尿剂用药、住院时间和医院死亡率的详细数据。瑞士气象局提供了每日温度（最高、平均、最低）和湿度数据。
该研究共纳入22239例患者。注意到有5个时期温度超过25°C持续3至5天，2个时期温度超过25°C持续超过5天。此外，在研究期间还注意到有2个时期每日温度超过30°C持续3至5天。我们发现炎热时期低钠血症的患病率显著增加。然而，在Cox回归分析中，长时间炎热与血清钠或钾紊乱的患病率无关。在炎热时期入院是医院死亡率的独立预测因素。
尽管我们发现炎热时期低钠血症的患病率有所增加，但未发现高钠血症或血清钾紊乱有令人信服的关联。
