Hyponatraemia in emergency medical admissions—outcomes and costs

Journal of Clinical Medicine

Volumn 3, Issue 4, 2014, Pages 1220-1233

  Conway, Richard ^a   Byrne, Declan ^a   O’riordan, Deirdre ^a   Silke, Bernard ^a  

^a ST JAMES S HOSPITAL   (Ireland)

Author keywords

Emergency admission; Hyponatraemia; Length of stay; Mortality

Indexed keywords

ACQUIRED IMMUNE DEFICIENCY SYNDROME; ADULT; AGED; ARTICLE; CHARLSON COMORBIDITY INDEX; DISABILITY SEVERITY; EMERGENCY HEALTH SERVICE; EMERGENCY WARD; FEMALE; HEALTH CARE QUALITY; HEART DISEASE; HOSPITAL ADMISSION; HOSPITAL COST; HOSPITAL DISCHARGE; HUMAN; HYPONATREMIA; INTENSIVE CARE UNIT; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MIDDLE AGED; MORTALITY; NEOPLASM; NEUROLOGIC DISEASE; PROSPECTIVE STUDY; REGRESSION ANALYSIS; RESPIRATORY TRACT DISEASE; SEVERITY OF ILLNESS INDEX; TREATMENT OUTCOME; VERY ELDERLY;

EID: 85020519914     PISSN: None     EISSN: 20770383     Source Type: Journal    
DOI: 10.3390/jcm3041220     Document Type: Article

References (45)

1. Kellett, J.; Deane, B. The Simple Clinical Score predicts mortality for 30 days after admission to an acute medical unit. QJM 2006, 99, 771–781.
2. Whelan, B.; Bennett, K.; O’Riordan, D.; Silke, B. Serum sodium as a risk factor for in-hospital mortality in acute unselected general medical patients. QJM 2009, 102, 175–182.
3. Asadollahi, K.; Beeching, N.; Gill, G. Hyponatraemia as a risk factor for hospital mortality. QJM 2006, 99, 877–880.
4. Stachon, A.; Segbers, E.; Hering, S.; Kempf, R.; Holland-Letz, T.; Krieg, M. A laboratory-based risk score for medical intensive care patients. Clin. Chem. Lab. Med. 2008, 46, 855–862.
5. Waikar, S.S.; Mount, D.B.; Curhan, G.C. Mortality after Hospitalization with Mild, Moderate, and Severe Hyponatremia. Am. J. Med. 2009, 122, 857–865.
6. Freire, A.X.; Bridges, L.; Umpierrez, G.E.; Kuhl, D.; Kitabchi, A.E. Admission Hyperglycemia and Other Risk Factors as Predictors of Hospital Mortality in a Medical ICU Population. Chest 2005, 128, 3109–3116.
7. Goldwasser, P.; Feldman, J. Association of serum albumin and mortality risk. J. Clin. Epidemiol. 1997, 50, 693–703.
8. Umpierrez, G.E.; Isaacs, S.D.; Bazargan, N.; You, X.; Thaler, L.M.; Kitabchi, A.E. Hyperglycemia: An Independent Marker of In-Hospital Mortality in Patients with Undiagnosed Diabetes. J. Clin. Endocrinol. MeTable 2002, 87, 978–982.
9. Suleiman, M.; Hammerman, H.; Boulos, M.; Kapeliovich, M.R.; Suleiman, A.; Agmon, Y.; Markiewicz, W.; Aronson, D. Fasting glucose is an important independent risk factor for 30 days mortality in patients with acute myocardial infarction: A prospective study. Circulation 2005, 111, 754–760.
10. Stranders, I.; Diamant, M.; van Gelder, R.E.; Spruijt, H.J.; Twisk, J.W.; Heinem, R.J.; Visser, F.C. Admission blood glucose level as risk indicator of death after myocardial infarction in patients with and without diabetes mellitus. Arch. Intern. Med. 2004, 164, 982–988.
11. Krinsley, J.S. Association between hyperglycemia and in-creased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin. Proc. 2003, 78, 1471–1478.
12. Lim, W.S.; Baudouin, S.V.; George, R.C.; Hill, A.T.; Jamieson, C.; le Jeune, L.; Macfarlane, J.T.; Read, R.C.; Roberts, H.J.; Levy, M.L. et al. BTS Guidelines for the Management of Community Acquired Pneumonia in Adults. Thorax 2009, 64, doi:10.1136/thx.2009.121434.
13. Silke, B.; Kellett, J.; Rooney, T.; Bennett, K.; O’Riordan, D. An improved medical admissions risk system using multivariable fractional polynomial logistic regression modelling. QJM 2010, 103, 23–32.
14. Asadollahi, K.; Hastings, I.M.; Beeching, N.J.; Gill, G.V. Laboratory risk factors for hospital mortality in acutely admitted patients. QJM 2007, 100, 501–507.
15. Froom, P.; Shimoni, Z. Prediction of hospital mortality rates by admission laboratory tests. Clin. Chem. 2006, 52, 325–328.
16. Subbe, C.P.; Kruger, M.; Rutherford, P.; Gemmel, L. Validation of a modified early warning score in medical admissions. QJM 2001, 94, 521–556.
17. Rhee, K.; Fisher, C.; Willitis, N. The Rapid Acute Physiology Score. Am. J. Emerg. Med. 1987, 5, 278–286.
18. Goodacre, S.; Turner, T.; Nicholl, J. Prediction of mortality among emergency medical admissions. Emerg. Med. J. 2006, 23, 371–375.
19. Reynolds, R.M.; Padfield, P.L.; Seckl, J.R. Disorders of sodium balance. BMJ 2006, 332, 702–705.
20. Holland-Bill, L.; Christiansen, C.F.; Ulrichsen, S.P.; Ring, T.; Jørgensen, J.O.; Sørensen, H.T. Validity of the International Classification of Diseases, 10th revision discharge diagnosis codes for hyponatraemia in the Danish National Registry of Patients. BMJ Open 2014, 4, doi:10.1136/bmjopen-2014-004956.
21. Nardi, R.; Fiorino, S.; Borioni, D.; Agostini, D.; D’Anastasio, C.; Marchetti, C.; Muratori, M. Comprehensive complexity assessment as a key tool for the prediction of in-hospital mortality in heart failure of aged patients admitted to internal medicine wards. Arch. Gerontol. Geriatr. 2007, 44, 279–288.
22. Wartenberg, K.E.; Schmidt, J.M.; Claassen, J.; Temes, R.E.; Frontera, J.A.; Ostapkovich, N.; Parra, A.; Connolly, E.S.; Mayer, S.A. Impact of medical complications on outcome after subarachnoid hemorrhage. Crit Care Med. 2006, 34, 617–623.
23. Kraft, M.D.; Btaiche, I.F.; Sacks, G.S.; Kudsk, K.A. Treatment of electrolyte disorders in adult patients in the intensive care unit. Am. J. Health Syst. Pharm. 2005, 62, 1663–1682.
24. Gheorghiade, M.; Abraham, W.T.; Albert, N.M.; Gattis Stough, W.; Greenberg, B.H.; O’Connor, C.M.; She, L.; Yancy, C.W.; Young, J.; Fonarow, G.C.; et al. Relationship between admission serum sodium concentration and clinical outcomes in patients hospitalized for heart failure: An analysis from the OPTIMIZE-HF registry. Eur. Heart J. 2007, 28, 980–988.
25. Mohammed, A.A.; van Kimmenade, R.R.; Richards, M.; Bayes-Genis, A.; Pinto, Y.; Moore, S.A.; Januzzi, J.L., Jr. Hyponatremia, natriuretic peptides, and outcomes in acutely decompensated heart failure: Results from the International Collaborative of NT-proBNP Study. Circ. Heart Fail. 2010, 3, 354–361.
26. Forfia, P.R.; Mathai, S.C.; Fisher, M.R.; Housten-Harris, T.; Hemnes, A.R.; Champion, H.C.; Girgis, R.E.; Hassoun, P.M. Hyponatremia Predicts Right Heart Failure and Poor Survival in Pulmonary Arterial Hypertension. Am. J. Respir. Crit Care Med. 2008, 177, 1364–1349.
27. Chawla, A.; Sterns, R.H.; Nigwekar, S.U.; Cappuccio, J.D. Mortality and serum sodium: Do patients die from or with hyponatremia? Clin. J. Am. Soc. Nephrol. 2011, 6, 960–965.
28. Rooney, T.; Moloney, E.D.; Bennett, K.; O’Riordan, D.; Silke, B. Impact of an acute medical admission unit on hospital mortality: A 5 year prospective study. QJM 2008, 101, 457–465.
29. Conway, R.; O’Riordan, D.; Silke, B. Long-term outcome of an AMAU—A decade’s experience. QJM 2014, 107, 43–49.
30. O’Callaghan, A.; Colgan, M.P.; McGuigan, C.; Smyth, F.; Haider, N.; O’Neill, S.; Moore, D.; Madhavan, P. A critical evaluation of HIPE data. Ir. Med. J. 2012, 105, 21–23.
31. O’Sullivan, E.; Callely, E.; O’Riordan, D.; Bennett, K.; Silke, B. Predicting outcomes in emergency medical admissions—Role of laboratory data and co-morbidity. Acute Med. 2012, 2, 59–65.
32. Charlson, M.E.; Pompei, P.; Ales, K.L.; MacKenzie, C.R. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J. Chronic. Dis. 1987, 40, 373–383.
33. Manchester Triage Group. Emergency Triage, 2nd ed.; Blackwell Publishing Ltd.: London, UK, 2006.
34. Chotirmall, S.H.; Picardo, S.; Lyons, J.; D’Alton, M.; O’Riordan, D.; Silke, B. Disabling disease codes predict worse outcomes for acute medical admissions. Intern. Med. J. 2014, 44, 546–553.
35. Mikulich, O.; Callaly, E.; Bennett, K.; O’Riordan, D.; Silke, B. The increased mortality associated with a weekend emergency admission is due to increased illness severity and altered case-mix. Acute Med. 2011, 10, 182–187.
36. Armstrong, P. The Costs of Activity-Based Management. Account. Organ. Soc. 2002, 27, 99–120.
37. Arnaboldi, M.; Lapsley, I. Modern costing innovations and legitimation: A health care study. Abacus 2004, 40, 1–20.
38. Williams, R. Using the margins command to estimate and interpret adjusted predictions and marginal effects. Stata J. 2012, 12, 308–331.
39. Cameron, A.C.; Trivedi, P.K. Microeconometrics Using Stata; Stata Press: College Station, TX, USA, 2009.
40. Stoltzfus, J.; Nishijima, D.; Melnikow, J. Why Quantile Regression Makes Good Sense for Analyzing Economic Outcomes in Medical Research. Acad. Emerg. Med. 2012, 19, 850–851.
41. Cody, C.S.; Clark, A.E.; Thomas, A.M.; Cook, L.J. Comparing least-squares and quantile regression approaches to analyzing median hospital charges. Acad. Emerg. Med. 2012, 19, 866–875.
42. Koenker, R. Confidence intervals for regression quantiles. In Asymptotic Statistics, Proceedings of the Fifth Prague Symposium, Prague, 4–9 September 1993; Koenker, R., Ed.; Springer: Heidelberg, Gemany, 1993.
43. Wald, R.; Jaber, B.L.; Price, L.L.; Upadhyay, A.; Madias, N.E. Impact of Hospital-Associated Hyponatremia on Selected Outcomes. Arch. Intern. Med. 2010, 170, 294–302.
44. Assen, A.; Abouem, D.; Vandergheynst, F.; Nguyen, T.; Taccone, F.S.; Melot, C. Hyponatremia at the Emergency Department: A case-control study. Minerva Anestesiol. 2014, 80, 419–428.
45. Tzoulis, P.; Bagkeris, E.; Bouloux, P.M. A case—Control study of hyponatraemia as an independent risk factor for inpatient mortality. Clin. Endocrinol. 2014, 81, 401–407.