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Hypernatremia increases mortality risk during hospitalization
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Older adults with hypernatremia admitted to the hospital have a higher mortality rate compared with those without hypernatremia, researchers recently reported.
Gabriel Munter, MD, of Shaare Zedek Medical Center in Jerusalem, and colleagues conducted a case-control study with 33 adults with hypernatremia (older than 70 years; admission sodium > 150 meq/L) compared with 30 adults without hypernatremia hospitalized on an internal medicine ward. Researchers sought to determine demographic and clinical characteristics among the populations and to enhance understanding of the role of antidiuretic hormone secretion on the pathogenesis of hypernatremia.
At admission, demographic, functional and clinical data and serum copeptin levels (used as a marker of antidiuretic hormone secretion) were collected. Participants were followed up to 30 days after discharge for mortality and change in functional status.
Compared with participants without hypernatremia, participants with hypernatremia had lower baseline functional and cognitive states, lower albumin levels (P < .05) and higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (P < .01).
Participants with hypernatremia had higher overall mortality from admission until 30 days from discharge (58%) compared with participants without hypernatremia (32%; P < .05), as well as higher copeptin levels (100.2 pmol/L vs. 66.5 pmol/L; P < .05).
In an evaluation of all participants, those with severe dementia had higher levels of copeptin. Higher mortality rates were associated with higher copeptin levels. Compared with participants who were discharged, those who died during hospitalization and those who died within 30 days of discharge had higher copeptin levels compared with those who survived (hospital death, P < .05; postdischarge death, P < .01).
“Hypernatremia in hospitalized elderly patients is highly predictive of mortality, although it is difficult to determine whether hypernatremia is the cause or just a marker,” the researchers wrote. “In contrast with previous studies, high copeptin levels were found in the hypernatremic group. Copeptin levels correlated with sodium levels, yet, an even stronger correlation was found between copeptin and APACHE II scores. This correlation supports the role of copeptin as a biomarker of severity of disease in the elderly.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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