title: Is Admission Serum Sodium Concentration a Clinical Predictor for the Outcome of Therapy in Critically Ill Poisoned Patients?
abstract: BACKGROUND
  Disorders of serum sodium concentration are some of the most electrolyte abnormalities in the intensive care unit (ICU) patients. These disorders adversely affect the function of vital organs and are associated with increased hospital mortality.
  
  
  OBJECTIVE
  In the present study we aimed to evaluate the effects of serum sodium concentration abnormalities at the time of hospital admission on the clinical outcome of therapy in a cohort of critically ill poisoned patients.
  
  
  METHODS
  In this cross-sectional study, 184 critically ill poisoned patients aged >18 years and in the first 8 hours of their poisoning, hospitalized in the ICU of a tertiary care university hospital (Isfahan, Iran) between 2010-2012, were evaluated at the admission time and 24 hours later for serum sodium concentration abnormalities and its relationship with age, gender, consciousness status, ingested drugs and clinical outcome of therapy. The clinical outcome was considered as recovery and mortality. Logistic Regression analysis was performed for predictive variables including serum sodium concentration abnormalities in patients' clinical outcome.
  
  
  RESULTS
  On admission, 152 patients (82.6%) were eunatremic, 21 patients (11.4%) were hyponatremic and 11 patients (6%) were hypernatremic. In the second day eunatremia, hyponatremia and hypernatremia was observed in 84.4%, 13% and 2.2% respectively. Age (OR=1.92; CI=1.18-3.12) and severity of toxicity (OR=1.32; CI=1.12-2.41) were predicting factors of mortality in ICU poisoning patients.
  
  
  CONCLUSIONS
  Serum sodium concentration abnormalities are prevalent in critically ill poisoned patient but do not seem to have a predictive value for the clinical outcome of therapy.
authors.affiliation: Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Nastaran
authors.initials: N
authors.lastname: Eizadi-Mood
authors.affiliation: Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ali Mohammad
authors.initials: AM
authors.lastname: Sabzghabaee
authors.affiliation: Department of Clinical Toxicology, Noor and Ali-Asghar [PBUH] university hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hosseini
authors.affiliation: Department of Pulmonary, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
authors.forename: Forough
authors.initials: F
authors.lastname: Soltaninejad
authors.affiliation: Department of Clinical Toxicology, Noor and Ali-Asghar [PBUH] university hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Massoumi
authors.affiliation: Departments of Health and Social Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ziba
authors.initials: Z
authors.lastname: Farajzadegan
authors.affiliation: Department of Clinical Toxicology, Noor and Ali-Asghar [PBUH] university hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Yaraghi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000097:blood*; D011237:Predictive Value of Tests; D012737:Sex Factors; D012964:Sodium / Q000097:blood*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012964:Sodium
keywords: ICU; hypernatremia; hyponatremia; poisoning