Tannor Elliot Koranteng, Agyei Martin, Tannor Abena Y, Ofori Afua, Akumiah Emmanuel, Boateng Yasmin Adoma
Renal Unit, Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Department of Internal Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Int J Nephrol. 2020 Nov 22;2020:3145843. doi: 10.1155/2020/3145843. eCollection 2020.
Hyponatraemia is the most common electrolyte abnormality in hospital admissions. It occurs in a quarter of medical admissions in Ghana, and it is associated with high mortality. Mortality has been suggested to be due to the underlying medical condition and not necessarily the hyponatraemia. We set out to compare the outcomes of patients with documented hyponatraemia as compared to those with normonatraemia in terms of mortality and length of hospital stay.
We conducted a comparative analysis of patients with hyponatraemia and those with normonatraemia on the medical ward at the Komfo Anokye Teaching Hospital between May 2018 and December 2018. The medical diagnoses, demographics, and laboratory data of the patients were recorded. Participants' age and gender were matched. Student's -test was used to test for differences in continuous variables when parametric and Wilcoxon signed-rank test for nonparametric variables. Multiple logistic regression was used to identify predictors of in-hospital mortality. A value of <0.05 was considered statistically significant.
Within the study period, 846 patients with documented serum sodium were included in the study. The study involved 406 patients with hyponatraemia and 440 patients with normonatraemia. Serum albumin and protein were significantly lower in the hyponatraemia patients as compared to those with normonatraemia. The mortality rate in patients with hyponatraemia was significantly higher than those with normonatraemia (129 (31.8%) vs. 9 (22.3%); OR 1.62 (95% CI: 1.19-2.22), = 0.002). In-hospital stay was longer in patients with hyponatraemia than normonatraemia (7 (4-10) vs. 6 (3-10) days) but not statistically significant ( = 0.09). Multiple logistic regression showed that low serum sodium ( < 0.001) and low serum albumin ( = 0.009) were the predictors of in-hospital mortality.
Hyponatraemia is associated with significantly higher mortality than normonatraemia and predicts worse prognosis in patients on medical admission. Low serum albumin is also a predictor of mortality in medical admission.
低钠血症是住院患者中最常见的电解质异常。在加纳，四分之一的内科住院患者会出现低钠血症，且其与高死亡率相关。有人认为死亡率是由潜在的基础疾病导致，而不一定是低钠血症本身。我们旨在比较有低钠血症记录的患者与血钠正常患者在死亡率和住院时间方面的结局。
我们对2018年5月至2018年12月在Komfo Anokye教学医院内科病房的低钠血症患者和血钠正常患者进行了对比分析。记录患者的医学诊断、人口统计学资料及实验室数据。对参与者的年龄和性别进行匹配。当变量为参数变量时，使用学生t检验来检验连续变量的差异；对于非参数变量，使用Wilcoxon符号秩检验。采用多元逻辑回归来确定院内死亡的预测因素。P值<0.05被认为具有统计学意义。
在研究期间，846例有血清钠记录的患者被纳入研究。该研究包括406例低钠血症患者和440例血钠正常患者。与血钠正常患者相比，低钠血症患者的血清白蛋白和蛋白水平显著更低。低钠血症患者的死亡率显著高于血钠正常患者（129例（31.8%）对9例（2.23%）；比值比1.62（95%可信区间：1.19 - 2.22），P = 0.002）。低钠血症患者的住院时间比血钠正常患者长（7（4 - 10）天对6（3 - 10）天），但差异无统计学意义（P = 0.09）。多元逻辑回归显示，低血清钠（P<0.001）和低血清白蛋白（P = 0.009）是院内死亡的预测因素。
与血钠正常相比，低钠血症与显著更高的死亡率相关，并预示内科住院患者预后更差。低血清白蛋白也是内科住院患者死亡的一个预测因素。
