Hyponatremia is an independent predictor of adverse clinical outcomes in hospitalized patients due to worsening heart failure

Sanae Hamaguchi, Shintaro Kinugawa, Miyuki Tsuchihashi-Makaya, Shoji Matsushima, Mamoru Sakakibara, Naoki Ishimori, Daisuke Goto, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background and purpose: Hyponatremia is common and is associated with poor in-hospital outcomes in patients hospitalized with heart failure (HF). However, it is unknown whether hyponatremia is associated with long-term adverse outcomes. The purpose of this study was to clarify the characteristics, clinical status on admission, and management during hospitalization according to the serum sodium concentration on admission, and determine whether hyponatremia was associated with in-hospital as well as long-term outcomes in 1677 patients hospitalized with worsening HF on index hospitalization registered in the database of the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Methods and subjects: We studied the characteristics and in-hospital treatment in 1659 patients hospitalized with worsening HF by using the JCARE-CARD database. Patients were divided into 2 groups according to serum sodium concentration on admission <135. mEq/mL (n= 176; 10.6%) or ≥135. mEq/mL (n= 1483; 89.4%). Results: The mean age was 70.7 years and 59.2% were male. Etiology was ischemic in 33.9% and mean left ventricular ejection fraction was 42.4%. After adjustment for covariates, hyponatremia was independently associated with in-hospital death [adjusted odds ratio (OR) 2.453, 95% confidence interval (CI) 1.265-4.755, p= 0.008]. It was significantly associated also with adverse long-term (mean 2.1. ±. 0.8 years) outcomes including all-cause death (OR 1.952, 95% CI 1.433-2.657), cardiac death (OR 2.053, 95% CI 1.413-2.983), and rehospitalization due to worsening HF (OR 1.488, 95% CI 1.134-1.953). Conclusions: Hyponatremia was independently associated with not only in-hospital but also long-term adverse outcomes in patients hospitalized with worsening HF.

Original languageEnglish
Pages (from-to)182-188
Number of pages7
JournalJournal of Cardiology
Volume63
Issue number3
DOIs
Publication statusPublished - Mar 1 2014
Externally publishedYes

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Hyponatremia
Heart Failure
Odds Ratio
Confidence Intervals
Hospitalization
Sodium
Databases
Cardiology
Serum
Stroke Volume
Registries
Cause of Death

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Hyponatremia is an independent predictor of adverse clinical outcomes in hospitalized patients due to worsening heart failure. / Hamaguchi, Sanae; Kinugawa, Shintaro; Tsuchihashi-Makaya, Miyuki; Matsushima, Shoji; Sakakibara, Mamoru; Ishimori, Naoki; Goto, Daisuke; Tsutsui, Hiroyuki.

In: Journal of Cardiology, Vol. 63, No. 3, 01.03.2014, p. 182-188.

Research output: Contribution to journalArticle

Hamaguchi, Sanae ; Kinugawa, Shintaro ; Tsuchihashi-Makaya, Miyuki ; Matsushima, Shoji ; Sakakibara, Mamoru ; Ishimori, Naoki ; Goto, Daisuke ; Tsutsui, Hiroyuki. / Hyponatremia is an independent predictor of adverse clinical outcomes in hospitalized patients due to worsening heart failure. In: Journal of Cardiology. 2014 ; Vol. 63, No. 3. pp. 182-188.
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abstract = "Background and purpose: Hyponatremia is common and is associated with poor in-hospital outcomes in patients hospitalized with heart failure (HF). However, it is unknown whether hyponatremia is associated with long-term adverse outcomes. The purpose of this study was to clarify the characteristics, clinical status on admission, and management during hospitalization according to the serum sodium concentration on admission, and determine whether hyponatremia was associated with in-hospital as well as long-term outcomes in 1677 patients hospitalized with worsening HF on index hospitalization registered in the database of the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Methods and subjects: We studied the characteristics and in-hospital treatment in 1659 patients hospitalized with worsening HF by using the JCARE-CARD database. Patients were divided into 2 groups according to serum sodium concentration on admission <135. mEq/mL (n= 176; 10.6{\%}) or ≥135. mEq/mL (n= 1483; 89.4{\%}). Results: The mean age was 70.7 years and 59.2{\%} were male. Etiology was ischemic in 33.9{\%} and mean left ventricular ejection fraction was 42.4{\%}. After adjustment for covariates, hyponatremia was independently associated with in-hospital death [adjusted odds ratio (OR) 2.453, 95{\%} confidence interval (CI) 1.265-4.755, p= 0.008]. It was significantly associated also with adverse long-term (mean 2.1. ±. 0.8 years) outcomes including all-cause death (OR 1.952, 95{\%} CI 1.433-2.657), cardiac death (OR 2.053, 95{\%} CI 1.413-2.983), and rehospitalization due to worsening HF (OR 1.488, 95{\%} CI 1.134-1.953). Conclusions: Hyponatremia was independently associated with not only in-hospital but also long-term adverse outcomes in patients hospitalized with worsening HF.",
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T1 - Hyponatremia is an independent predictor of adverse clinical outcomes in hospitalized patients due to worsening heart failure

AU - Hamaguchi, Sanae

AU - Kinugawa, Shintaro

AU - Tsuchihashi-Makaya, Miyuki

AU - Matsushima, Shoji

AU - Sakakibara, Mamoru

AU - Ishimori, Naoki

AU - Goto, Daisuke

AU - Tsutsui, Hiroyuki

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Y1 - 2014/3/1

N2 - Background and purpose: Hyponatremia is common and is associated with poor in-hospital outcomes in patients hospitalized with heart failure (HF). However, it is unknown whether hyponatremia is associated with long-term adverse outcomes. The purpose of this study was to clarify the characteristics, clinical status on admission, and management during hospitalization according to the serum sodium concentration on admission, and determine whether hyponatremia was associated with in-hospital as well as long-term outcomes in 1677 patients hospitalized with worsening HF on index hospitalization registered in the database of the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Methods and subjects: We studied the characteristics and in-hospital treatment in 1659 patients hospitalized with worsening HF by using the JCARE-CARD database. Patients were divided into 2 groups according to serum sodium concentration on admission <135. mEq/mL (n= 176; 10.6%) or ≥135. mEq/mL (n= 1483; 89.4%). Results: The mean age was 70.7 years and 59.2% were male. Etiology was ischemic in 33.9% and mean left ventricular ejection fraction was 42.4%. After adjustment for covariates, hyponatremia was independently associated with in-hospital death [adjusted odds ratio (OR) 2.453, 95% confidence interval (CI) 1.265-4.755, p= 0.008]. It was significantly associated also with adverse long-term (mean 2.1. ±. 0.8 years) outcomes including all-cause death (OR 1.952, 95% CI 1.433-2.657), cardiac death (OR 2.053, 95% CI 1.413-2.983), and rehospitalization due to worsening HF (OR 1.488, 95% CI 1.134-1.953). Conclusions: Hyponatremia was independently associated with not only in-hospital but also long-term adverse outcomes in patients hospitalized with worsening HF.

AB - Background and purpose: Hyponatremia is common and is associated with poor in-hospital outcomes in patients hospitalized with heart failure (HF). However, it is unknown whether hyponatremia is associated with long-term adverse outcomes. The purpose of this study was to clarify the characteristics, clinical status on admission, and management during hospitalization according to the serum sodium concentration on admission, and determine whether hyponatremia was associated with in-hospital as well as long-term outcomes in 1677 patients hospitalized with worsening HF on index hospitalization registered in the database of the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Methods and subjects: We studied the characteristics and in-hospital treatment in 1659 patients hospitalized with worsening HF by using the JCARE-CARD database. Patients were divided into 2 groups according to serum sodium concentration on admission <135. mEq/mL (n= 176; 10.6%) or ≥135. mEq/mL (n= 1483; 89.4%). Results: The mean age was 70.7 years and 59.2% were male. Etiology was ischemic in 33.9% and mean left ventricular ejection fraction was 42.4%. After adjustment for covariates, hyponatremia was independently associated with in-hospital death [adjusted odds ratio (OR) 2.453, 95% confidence interval (CI) 1.265-4.755, p= 0.008]. It was significantly associated also with adverse long-term (mean 2.1. ±. 0.8 years) outcomes including all-cause death (OR 1.952, 95% CI 1.433-2.657), cardiac death (OR 2.053, 95% CI 1.413-2.983), and rehospitalization due to worsening HF (OR 1.488, 95% CI 1.134-1.953). Conclusions: Hyponatremia was independently associated with not only in-hospital but also long-term adverse outcomes in patients hospitalized with worsening HF.

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