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  • Title: Frequency and outcomes of hyponatremic patients with heart failure hospitalized in the Clinical Emergency Hospital of Bucharest.
    Author: Diaconu CC, Bartoş D.
    Journal: Rom J Intern Med; 2014; 52(1):24-6. PubMed ID: 25000674.
    Abstract:
    UNLABELLED: The purpose of the study was to analyze the frequency of hyponatremia and outcomes in patients with chronic heart failure consecutively admitted in the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, during a period of 8 months. METHODS: A total of 434 hospitalized patients with heart failure were included in the study. Serum sodium concentration was recorded at the day of admission in hospital, several times during hospitalization and at discharge. Patients were categorized with normonatremia (serum sodium concentration > 134 mEq/L on admission day), persistent hyponatremia (serum sodium level < 134 mEq/L on admission and throughout the hospitalization) and corrected hyponatremia (initial seric sodium < 134 mEq/L that increased to > 134 mEq/L during hospitalization). RESULTS: Hyponatremia was present in 127 patients (29.26%) on admission day and persisted during hospitalization in 91 out of 127 patients (71.65%). From the remaining 307 patients, 269 were normonatremic and 38 (12.37%) were missing serum sodium concentration data on admission day and were excluded from this analysis. Compared with normonatremic patients, those with persistent hyponatremia had lower systolic blood pressure and received higher doses of diuretics during hospitalization. Hyponatremia was associated with higher in-hospital mortality (19.78% of persistent hyponatremic patients) compared with normonatremic patients (1.48%). CONCLUSION: Persistent hyponatremia can be a predictor of mortality in hospitalized heart failure patients. In most patients, it is not corrected during hospitalization. Those with persistent hyponatremia usually received higher doses of diuretic. The duration of hospitalization is greater in patients with hyponatremia.
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