Serum sodium concentration and clinical outcomes in patients with heart failureAKU Symposium
LocationAuditorium Pond Side
Start Date26-2-2014 10:30 AM
AbstractIntroduction: The diagnosis of heart failure in a patient carries a prognosis of 35-40% 1-year mortality. Among factors predicting mortality, hyponatremia has been associated with 2-3 fold increase in in-hospital and post discharge mortality. There is paucity of data from Indo-Asian population on outcomes of heart failure and factors predicting mortality. Objectives: To compare 30-day mortality rate in heart failure patients with and without hyponatermia (serum sodium <136 and ≥136 mmol/L. respectively). To compare these two groups for length of stay, rate of rehospitalization and functional status (NYHA criteria). Materials and Methods: A prospective cohort study of 164 patients with heart failure was conducted. Patients were recruited from the emergency department of Aga Khan Univerity Hospital over a 6-month period. Patients with and without hyponatremia were followed for death, length of hospital stay, rehospitalization and functional status at 30 days. Data was analyzed using SPSS version 16.0 and a P-value of <0.05 was considered statistically. Results: The average age was 64±13 years, and 55% of patients were male. Comorbids: 92% had Hypertension, 88% had Coronary Artery Disease, 62% had Diabetes Mellitus, 40% had Chronic Kidney disease. Mortality This was 4% in patients with normal serum sodium and 10% in patients with hyponatremia. Multivariate analysis: The odds of having sodium < 136mmol/l among those who died was 3.04 (95% CI 0.77-12.04) as compared to those who survived, though this was not statistically significant (p=0.113). The odds of having hyponatremia among those who had good NYHA functional class was 0.16 (CI 0.07-0.34) compared to those with poor NYHA functional class (p<0.001). The odds of having hyponatremia among those who were re-hospitalized was 0.2 (CI 0.05-0.78) times that of those who were not re-hospitalized (p=0.021). Conclusion: Hyponatremia (serum sodium <136mmol/L) in heart fauilure was associated with a tendency towards higher mortality, though not statistically significant. Hyponatremia was significantly associated with lower re-hospitalization rate and poor NYHA functional class. A study with larger sample size or longer follow up period may identify significance of hyponatremia as a predictor of mortality, hence relevant interventions can be targeted to improve outcome.
Citation InformationNoreen Nasir, Aysha Almas and Bushra Jamil. "Serum sodium concentration and clinical outcomes in patients with heart failure" (2014)
Available at: http://works.bepress.com/bushra_jamil/62/