Tokgöz Akyil Fatma, Akyil Mustafa, Çoban Ağca Meltem, Güngör Aylin, Ozantürk Erdal, Söğüt Gökhan, Alparslan Bekir Sümeyye, Topbaş Ahmet, Türker Hatice, Sevim Tülin
Clinic of Chest Diseases, Canakkale Mehmet Akif Ersoy State Hospital, Canakkale, Turkey.
Clinic of Chest Surgery, Canakkale Mehmet Akif Ersoy State Hospital, Canakkale, Turkey.
Tuberk Toraks. 2019 Dec;67(4):239-247. doi: 10.5578/tt.68779.
Dysnatremia is reported to have a prognostic effect in various diseases. A limited number of studies have been published on dysnatremiarelated parameters and clinical outcome in patients with pneumonia. The aim of the study is to analyze the factors related to baseline dysnatremia and to evaluate the clinical outcome of dysnatremia on hospital stay, 30-day and 1-year mortality in hospitalized patients with community-acquired pneumonia (CAP).
The study is a two-centre, retrospective, crosssectional study. According to the baseline corrected sodium values, hospitalized patients with CAP were grouped as hyponatremia (<135 mmol/L), normonatremia (135-145 mmol/L) and hypernatremia (> 145 mmol/L).
Of all the 471 patients included, 119 (25.3%) had hyponatremia and 25 (5.3%) had hypernatremia. Higher leucocytes and lower albumin values correlated with hyponatremia while female gender, higher leucocytes and urea levels correlated with hypernatremia. Baseline hyponatremia prolonged hospital stay (9.2 ± 5.6, vs. 7.5 ± 4.6, respectively, p= 0.001) and increased 1-year mortality. On the other hand, hypernatremia predicted 30-day (40%, vs. 10%, p<0.001) and independently predicted 1-year mortality (p< 0.001).
In hospitalized patients with CAP, baseline hyponatremia prolongs hospital stay while hypernatremia signals a worse outcome both in the short term and long term.
据报道，钠代谢紊乱在各种疾病中都有预后影响。关于肺炎患者钠代谢紊乱相关参数和临床结局的研究发表数量有限。本研究的目的是分析与基线钠代谢紊乱相关的因素，并评估钠代谢紊乱对社区获得性肺炎（CAP）住院患者住院时间、30天和1年死亡率的临床结局。
本研究是一项双中心、回顾性横断面研究。根据基线校正钠值，将CAP住院患者分为低钠血症（<135 mmol/L）、正常钠血症（135 - 145 mmol/L）和高钠血症（>145 mmol/L）。
在纳入的471例患者中，119例（25.3%）有低钠血症，25例（5.3%）有高钠血症。白细胞计数升高和白蛋白值降低与低钠血症相关，而女性、白细胞计数升高和尿素水平与高钠血症相关。基线低钠血症延长了住院时间（分别为9.2±5.6天和7.5±4.6天，p = 0.001）并增加了1年死亡率。另一方面，高钠血症预测了30天死亡率（40%对10%，p<0.001）并独立预测了1年死亡率（p<0.001）。
在CAP住院患者中，基线低钠血症会延长住院时间，而高钠血症在短期和长期都预示着更差的结局。
