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低钠血症对慢性阻塞性肺疾病急性加重预后的影响。

Impact of Hyponatremia on COPD Exacerbation Prognosis.

作者信息

García-Sanz María-Teresa, Martínez-Gestoso Sandra, Calvo-Álvarez Uxío, Doval-Oubiña Liliana, Camba-Matos Sandra, Rábade-Castedo Carlos, Rodríguez-García Carlota, González-Barcala Francisco-Javier

机构信息

Emergency Department, Salnés County Hospital, 36600 Vilagarcía de Arousa, Spain.

Respiratory Medicine Department, Hospital Arquitecto Marcide, 15405 Ferrol, Spain.

出版信息

J Clin Med. 2020 Feb 12;9(2):503. doi: 10.3390/jcm9020503.

Abstract

The most common electrolyte disorder among hospitalized patients, hyponatremia is a predictor of poor prognosis in various diseases. The aim of this study was to establish the prevalence of hyponatremia in patients admitted for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), as well as its association with poor clinical progress Prospective observational study carried out from 1 October 2016 to 1 October 2018 in the following hospitals: Salnés in Vilagarcía de Arousa, Arquitecto Marcide in Ferrol, and the University Hospital Complex of Santiago de Compostela, Galicia, Spain, on patients admitted for AECOPD. Patient baseline treatment was identified, including hyponatremia-inducing drugs. Poor progress was defined as follows: prolonged stay, death during hospitalization, or readmission within one month after the index episode discharge. 602 patients were enrolled, 65 cases of hyponatremia (10.8%) were recorded, all of a mild nature (mean 131.6; SD 2.67). Of all the patients, 362 (60%) showed poor progress: 18 (3%) died at admission; 327 (54.3%) had a prolonged stay; and 91 (15.1%) were readmitted within one month after discharge. Patients with hyponatremia had a more frequent history of atrial fibrillation (AF) ( 0.005), pleural effusion ( 0.01), and prolonged stay ( 0.01). The factors independently associated with poor progress were hyponatremia, pneumonia, and not receiving home O treatment prior to admission. Hyponatremia is relatively frequent in patients admitted for AECOPD, and it has important prognostic implications, even when mild in nature.

摘要

低钠血症是住院患者中最常见的电解质紊乱,是多种疾病预后不良的一个预测指标。本研究的目的是确定因慢性阻塞性肺疾病急性加重(AECOPD)入院患者的低钠血症患病率,以及其与临床进展不良的关联。2016年10月1日至2018年10月1日在西班牙加利西亚的以下医院开展了一项前瞻性观察研究:比利亚加西亚德阿罗萨的萨尔内斯医院、费罗尔的马克西德建筑师医院和圣地亚哥德孔波斯特拉大学综合医院,研究对象为因AECOPD入院的患者。确定了患者的基线治疗情况,包括导致低钠血症的药物。进展不良的定义如下:住院时间延长、住院期间死亡或在首次发作出院后1个月内再次入院。共纳入602例患者,记录到65例低钠血症(10.8%),均为轻度(平均131.6;标准差2.67)。在所有患者中,362例(60%)显示进展不良:18例(3%)入院时死亡;327例(54.3%)住院时间延长;91例(15.1%)在出院后1个月内再次入院。低钠血症患者房颤(AF)病史更常见(P=0.005)、胸腔积液更常见(P=0.01)、住院时间延长更常见(P=0.01)。与进展不良独立相关的因素是低钠血症、肺炎以及入院前未接受家庭氧疗。低钠血症在因AECOPD入院的患者中相对常见,即使是轻度低钠血症也具有重要的预后意义。

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