title: Impact of hyponatremia on mortality and morbidity in patients with COPD exacerbations.
abstract: Hyponatremia is the most common electrolyte disorder in hospitalized patients, being associated with increased morbidity and mortality in different clinical conditions. However, the prevalence and impact of this electrolytic disorder in patients hospitalized for an exacerbation of COPD still remains unknown. The aim of the present study was to clarify these points. A total of 424 patients hospitalized due to a COPD exacerbation were consecutively included, showing a frequency of hyponatremia of 15.8% (hyposmolar in most cases). Even though patients with and without hyponatremia showed a similar age, comorbidities, lung function impairment, presence of previous exacerbations, hospitalizations, most of the comorbidities and the overall severity index (APACHE II), their clinical outcomes were worse. Indeed, their hospitalization length, mechanical ventilation requirements and deaths (both during admission and within the months following discharge) were higher than those of non-hyponatremic patients. A sodium threshold lower than 129.7 mEq/L exhibited the better discriminatory power for death prediction. We conclude that hyponatremia (especially if severe) is a predictive marker for a bad clinical course in COPD exacerbations and therefore, patients with this electrolyte abnormality should be carefully monitored.
authors: Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CibeRes), ISCIII, Spain.
authors: Roberto
authors: R
authors: Chalela
authors: Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain.
authors: José Gregorio
authors: JG
authors: González-García
authors: Servei d'Endocrinologia i Nutrició, Hospital del Mar - IMIM, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: Juan José
authors: JJ
authors: Chillarón
authors: Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain.
authors: Leticia
authors: L
authors: Valera-Hernández
authors: Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain.
authors: Carlos
authors: C
authors: Montoya-Rangel
authors: Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CibeRes), ISCIII, Spain.
authors: Diana
authors: D
authors: Badenes
authors: Universitat Autònoma de Barcelona, Barcelona, Spain; Methodological Consulting in Biomedical Research, IMIM, Barcelona, Spain.
authors: Sergi
authors: S
authors: Mojal
authors: Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CibeRes), ISCIII, Spain. Electronic address: jgea@parcdesalutmar.cat.
authors: Joaquim
authors: J
authors: Gea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007010:Hyponatremia / Q000150:complications / Q000453:epidemiology* / Q000401:mortality*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D063868:Patient Outcome Assessment; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism / Q000401:mortality*; D012121:Respiration, Artificial / Q000401:mortality; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood
chemical_list: D015415:Biomarkers; D012964:Sodium
keywords: COPD; Clinical outcomes; Exacerbations; Hyponatremia