Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2017 Nov 22;17(1):152.
doi: 10.1186/s12911-017-0549-7.

Association between borderline dysnatremia and mortality insight into a new data mining approach

Yannick Girardeau  1   2   3 , Anne-Sophie Jannot  4   5 , Gilles Chatellier  4   6   7 , Olivier Saint-Jean  8
Affiliations
Observational Study

Association between borderline dysnatremia and mortality insight into a new data mining approach

Yannick Girardeau et al. BMC Med Inform Decis Mak. .

Abstract

Background: Even small variations of serum sodium concentration may be associated with mortality. Our objective was to confirm the impact of borderline dysnatremia for patients admitted to hospital on in-hospital mortality using real life care data from our electronic health record (EHR) and a phenome-wide association analysis (PheWAS).

Methods: Retrospective observational study based on patient data admitted to Hôpital Européen George Pompidou, between 01/01/2008 and 31/06/2014; including 45,834 patients with serum sodium determinations on admission. We analyzed the association between dysnatremia and in-hospital mortality, using a multivariate logistic regression model to adjust for classical potential confounders. We performed a PheWAS to identify new potential confounders.

Results: Hyponatremia and hypernatremia were recorded for 12.0% and 1.0% of hospital stays, respectively. Adjusted odds ratios (ORa) for severe, moderate and borderline hyponatremia were 3.44 (95% CI, 2.41-4.86), 2.48 (95% CI, 1.96-3.13) and 1.98 (95% CI, 1.73-2.28), respectively. ORa for severe, moderate and borderline hypernatremia were 4.07 (95% CI, 2.92-5.62), 4.42 (95% CI, 2.04-9.20) and 3.72 (95% CI, 1.53-8.45), respectively. Borderline hyponatremia (ORa = 1.57 95% CI, 1.35-1.81) and borderline hypernatremia (ORa = 3.47 95% CI, 2.43-4.90) were still associated with in-hospital mortality after adjustment for classical and new confounding factors identified through the PheWAS analysis.

Conclusion: Borderline dysnatremia on admission are independently associated with a higher risk of in-hospital mortality. By using medical data automatically collected in EHR and a new data mining approach, we identified new potential confounding factors that were highly associated with both mortality and dysnatremia.

Keywords: Borderline dysnatremia; Electronic health record; Hypernatremia; Hyponatremia; In-hospital mortality; Phenome-wide association analysis; Sodium.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the institutional review board of the HEGP (IRB#00001072 Study #CDW_2015_0013).

Consent for publication

All persons gave their informed consent prior to their inclusion in the study.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Algorithm Used to Define the Study Cohorts and Flow Chart
Fig. 2
Fig. 2
Unadjusted and Adjusted Risk of In-Hospital Mortality Estimated for Each Serum Sodium Level Group
See this image and copyright information in PMC

References

    1. Reynolds RM, Padfield PL, Seckl JR. Disorders of sodium balance. BMJ. 2006;332:702–705. doi: 10.1136/bmj.332.7543.702. - DOI - PMC - PubMed
    1. Arieff AI, Llach F, Massry SG. Neurological manifestations and morbidity of hyponatremia: correlation with brain water and electrolytes. Medicine (Baltimore) 1976;55:121–129. doi: 10.1097/00005792-197603000-00002. - DOI - PubMed
    1. Waikar SS, Mount DB, Curhan GC. Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med. 2009;122:857–865. doi: 10.1016/j.amjmed.2009.01.027. - DOI - PMC - PubMed
    1. Wald R, Jaber BL, Price LL, Upadhyay A, Madias NE. Impact of hospital-associated hyponatremia on selected outcomes. Arch Intern Med. 2010;170:294–302. doi: 10.1001/archinternmed.2009.513. - DOI - PubMed
    1. Funk G-C, Lindner G, Druml W, Metnitz B, Schwarz C, Bauer P, et al. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010;36:304–311. doi: 10.1007/s00134-009-1692-0. - DOI - PubMed

Publication types

LinkOut - more resources