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. 2022 Aug;111(8):1630-1637.
doi: 10.1111/apa.16348. Epub 2022 Apr 8.

The incidence, hospitalisations and deaths in acutely ill children with dysnatraemias

Saara Lehtiranta  1   2 , Minna Honkila  1   2 , Silja Anttila  2 , Heikki Huhtamäki  1   2 , Tytti Pokka  1   2 , Terhi Tapiainen  1   2   3
Affiliations

The incidence, hospitalisations and deaths in acutely ill children with dysnatraemias

Saara Lehtiranta et al. Acta Paediatr. 2022 Aug.

Abstract

Aim: The aim was to evaluate the incidence, hospitalisations and deaths in acutely ill children with dysnatraemias.

Methods: This was a register-based cohort study of 46 518 acutely ill children aged <16 years who visited a paediatric emergency department. Risk factors were assessed using two nested case-control studies.

Results: Moderate to severe hypernatraemia occurred in 92 children (0.20%; 95% confidence interval [CI]: 0.16%-0.24%) and moderate to severe hyponatraemia in 131 children (0.28%; 95% CI: 0.24%-0.33%). Underlying medical conditions increased the risk of both moderate to severe hypernatraemia (odds ratio [OR]: 17; 95% 5.5-51) and moderate to severe hyponatraemia (OR: 3.5; 95% CI: 2.0-5.9). The use of a feeding tube (OR: 14; 95% CI: 3.2-66) and intellectual disability (OR: 7.3; 95% CI: 3.0-18) was associated with moderate to severe hypernatraemia. The risk of death was associated with moderate to severe hypernatraemia (OR: 19; 95% CI: 2.0-2564) and moderate to severe hyponatraemia (OR: 33; 95% CI: 3.7-4311).

Conclusions: Severe dysnatraemias were more prevalent in acutely ill children with underlying medical conditions and were markedly associated with the risk for death.

Keywords: hypernatraemia; hyponatraemia; sodium disturbances; water-electrolyte imbalance.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study design. (A) Case–control cohort study of risk factors, deaths and hospitalisation for moderate to severe hypernatraemia. (B) Case–control study of risk factors, deaths and hospitalisation for moderate to severe hyponatraemia in the same cohort
FIGURE 2
FIGURE 2
Time to the development of moderate to severe hypernatraemia (sodium ≥150 mmol/L) and moderate to severe hyponatraemia (sodium <130 mmol/L) in acutely ill children. Day 0 refers to the presentation at the ED and day 1 to the first 24 h of hospitalisation
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