Hyponatremia in sick children: a marker of serious illness.
To study the association between hyponatremia (serum sodium < or = 130 mEq/L) and the final outcome of the illness, we correlated serum sodium concentration at the time of hospitalization with the length of hospital stay and mortality in a prospective study of 727 sick children aged upto 12 years, who sought emergency care. The mean +/- SE duration of hospital stay (7.7 +/- 0.4 days) among 217 children with serum sodium < or = 130 mEq/L was about 30% longer than that of 510 children with serum sodium > or = 131 mEq/L (5.9 +/- 0.3 days) (p < 0.01). This remained unaffected by the sex and the age group, but was further prolonged in children with hypotonic--euvolemic type of hyponatremia as compared to those with hypovolemic hyponatremia. The mortality rate in 510 children with normal serum sodium concentration (> or = 131 mEq/L) was 5.3%. In contrast, it was 17% in 47 children with serum sodium < 125 mEq/L (Relative Risk 3.2; 95% Confidence Interval 1.6-6.7) and 9.3% in 170 children with serum sodium between 126-130 mEq/L (Relative Risk--1.8; 95% Confidence Interval 1.1-3.7) (p < 0.01). Hyponatremia in acutely ill children at admission indicates a poor prognosis.
Singhi
S
S
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh.
Prasad
S V
SV
Chugh
K S
KS
D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology / Q000401:mortality*; D007194:India / Q000453:epidemiology; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012306:Risk; D012964:Sodium / Q000097:blood; D015996:Survival Rate
D012964:Sodium