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VOLUME 20 , ISSUE 10 ( 2016 ) > List of Articles

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Association of hyponatremia with in-hospital outcomes in infective endocarditis: A 5-year review from an Indian Intensive Care Unit

Saraschandra Vallabhajosyula, Muralidhar Varma, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula

Keywords : Heart failure, hospital outcomes, hyponatremia, India, infective endocarditis

Citation Information : Vallabhajosyula S, Varma M, Vallabhajosyula S, Vallabhajosyula S. Association of hyponatremia with in-hospital outcomes in infective endocarditis: A 5-year review from an Indian Intensive Care Unit. Indian J Crit Care Med 2016; 20 (10):597-600.

DOI: 10.4103/0972-5229.192051

License: CC BY-ND 3.0

Published Online: 00-10-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Hyponatremia is commonly noted with cardiovascular disorders, but its role in infective endocarditis (IE) is limited to being a marker of increased morbidity in IE patients with intravenous drug use. This was a 5-year retrospective review from an Indian Intensive Care Unit (ICU). Patients >18 years with IE and available serum sodium levels were included in the study. Pediatric and pregnant patients were excluded from the study. Hyponatremia was defined as admission sodium <135 mmol/L. Detailed data were abstracted from the medical records. Primary outcomes were need for invasive mechanical ventilation, ICU length of stay, and in-hospital mortality. Secondary outcomes included development of acute kidney injury, acute decompensated heart failure (ADHF), acute respiratory distress syndrome, stroke, and severe sepsis in the ICU. Two-tailed P < 0.05 was considered statistically significant. Between January 2010 and December 2014, 96 patients with IE were admitted to the ICU with 85 (88.5%) (median age 46 [34.5-55] years, 51 [60.0%] males) meeting our inclusion criteria. The comorbidities, echocardiographic, and microbiological characteristics were comparable between patients with hyponatremia (56; 65.9%) and eunatremia (29; 34.1%). Median sodium in the hyponatremic cohort was 131 mmol/L (127.25-133) compared to the eunatremic cohort 137 mmol/L (135-139) (P < 0.001). The primary outcomes were not different between the two groups. Hyponatremia was associated more commonly with ADHF (12 [21.4%] vs. 0; P = 0.007) during the ICU stay. Hyponatremia is commonly seen in IE patients and is not associated with worse hospital outcomes. ADHF was seen more commonly in the hyponatremic patients in comparison to those with eunatremia.


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  1. Tamizifar B, Kheiry S, Fereidoony F. Hyponatremia and 30 days mortality of patients with acute pulmonary embolism. J Res Med Sci 2015;20:777-81.
  2. Hoorn EJ, Zietse R. Hyponatremia and mortality: Moving beyond associations. Am J Kidney Dis 2013;62:139-49.
  3. Lu DY, Cheng HM, Cheng YL, Hsu PF, Huang WM, Guo CY, et al. Hyponatremia and worsening sodium levels are associated with long-term outcome in patients hospitalized for acute heart failure. J Am Heart Assoc 2016;5:e002668.
  4. Burkhardt K, Kirchberger I, Heier M, Zirngibl A, Kling E, von Scheidt W, et al. Hyponatraemia on admission to hospital is associated with increased long-term risk of mortality in survivors of myocardial infarction. Eur J Prev Cardiol 2015;22:1419-26.
  5. Rodriguez R, Alter H, Romero KL, Kea B, Chiang W, Fortman J, et al. A pilot study to develop a prediction instrument for endocarditis in injection drug users admitted with fever. Am J Emerg Med 2011;29:894-8.
  6. Ogbuawa O, Singleton G, Williams JT, Henry WL, Townsend JL. Blood chemistry abnormalities in bacterial endocarditis of narcotic addicts. South Med J 1978;71:1526-9.
  7. Levine DP, Crane LR, Zervos MJ. Bacteremia in narcotic addicts at the Detroit Medical Center. II. Infectious endocarditis: A prospective comparative study. Rev Infect Dis 1986;8:374-96.
  8. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American-European consensus conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994;149 (3 Pt 1):818-24.
  9. American College of Chest Physicians/Society of Critical Care Medicine consensus conference: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992;20:864-74.
  10. Vallabhajosyula S, Vallabhajosyula S, Vallabhajosyula S, Varma MD. Association of hyponatremia with in-hospital outcomes in infective endocarditis: A five-year review from an Indian Intensive Care Unit. Am J Respir Crit Care Med 2016;193:A6909.
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