Ouatu Anca, Mihai Madalina Stefana, Tanase Daniela Maria, Dascalu Cristina Gena, Dima Nicoleta, Serban Lacramioara Ionela, Rezus Ciprian, Floria Mariana
Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania.
Department of Internal Medicine, IIIrd Medical Clinic, "Sf. Spiridon" Emergency Hospital, 1 Independentei Street, 700111 Iasi, Romania.
Diagnostics (Basel). 2021 Feb 1;11(2):214. doi: 10.3390/diagnostics11020214.
Over recent years, studies have shown that in patients with left-sided heart failure, arterial hypertension, and acute coronary syndrome, hyponatremia is a negative prognostic factor. In this context, there is raising interest in the association between hyponatremia and pulmonary embolism (PE). This retrospective cohort study includes 404 consecutive patients with confirmed acute nonfatal pulmonary embolism divided into four groups according to their sodium fluctuation pattern. The primary outcome was all-cause mortality and determining the recurrence rate among patients with nonfatal PE using serum sodium levels as a continuous variable. Patients with acquired and persistent hyponatremia had a significantly higher rate of mortality rate than those in the normonatremia group (12.8% and 40.4%, OR- 7.206, CI: 2.383-21.791, = 0.000 and OR-33.250, CI: 11.521-95.960, = 0.000 vs. 2%, < 0.001, respectively). Mean survival time decreases from 23.624 months (95% CI: (23.295-23.953)) in the normonatremia group to 16.426 months (95% CI: (13.17-19.134)) in the persistent hyponatremia group, statistically significant ( = 0.000). The mean survival time for all patients was 22.441 months (95% CI: (21.930-22.951)). The highest recurrence rate was recorded at 12 and 24 months in the acquired hyponatremia group (16.7% and 14.1%, respectively). Serum sodium determination is a simple and cost-effective approach in evaluating the short and long-term prognosis in patients with acute PE.
近年来，研究表明，在左心衰竭、动脉高血压和急性冠状动脉综合征患者中，低钠血症是一个不良预后因素。在此背景下，人们对低钠血症与肺栓塞（PE）之间的关联越来越感兴趣。这项回顾性队列研究纳入了404例确诊为急性非致命性肺栓塞的连续患者，根据其钠波动模式分为四组。主要结局是全因死亡率，并将血清钠水平作为连续变量来确定非致命性PE患者的复发率。获得性和持续性低钠血症患者的死亡率显著高于正常钠血症组患者（分别为12.8%和40.4%，OR = 7.206，CI：2.383 - 21.791，P = 0.000；OR = 33.250，CI：11.521 - 95.960，P = 0.000，而正常钠血症组为2%，P < 0.001）。正常钠血症组的平均生存时间为23.624个月（95% CI：(23.295 - 23.953)），持续性低钠血症组降至16.426个月（95% CI：(13.17 - 19.134)），差异有统计学意义（P = 0.000）。所有患者的平均生存时间为22.441个月（95% CI：(21.930 - 22.951)）。获得性低钠血症组在12个月和24个月时的复发率最高（分别为16.7%和14.1%）。血清钠测定是评估急性PE患者短期和长期预后的一种简单且经济有效的方法。
