Risk Factors and Outcomes in Patients With Hypernatremia and Sepsis

Am J Med Sci. 2016 Jun;351(6):601-5. doi: 10.1016/j.amjms.2016.01.027. Epub 2016 Mar 31.

Abstract

Background: Hypernatremia is an uncommon but important electrolyte abnormality in intensive care unit patients. Sepsis is one of the most common causes of intensive care unit admission, but few studies about the role of hypernatremia in sepsis has been published yet. In this study, we aimed to explore the risk factors for developing hypernatremia in patients with sepsis, and the prognosis of patients with sepsis with or without hypernatremia was also assessed.

Materials and methods: In this retrospective cohort study of 51 septic intensive care unit patients at a single center, we examined the risk factors for the development of hypernatremia and the association of hypernatremia with clinical outcomes using univariate and multivariable analyses. Clinical outcomes such as mortality and hospital duration of patients with or without hypernatremia were also compared.

Results: Acute Physiology and Chronic Health Evaluation II score (odds ratio = 1.15; 95% CI: 1.022-1.294) was found to be the only independent risk factor for hypernatremia in patients with sepsis. Moreover, patients developing hypernatremia during hospitalization showed significantly higher morbidity and mortality.

Conclusions: Acute Physiology and Chronic Health Evaluation II score may be an independent risk factor for hypernatremia in patients with sepsis. Moreover, hypernatremia is strongly associated with worse outcome in sepsis.

Keywords: Hypernatremia; Prognosis; Risk factors; Sepsis.

Publication types

  • Observational Study

MeSH terms

  • APACHE
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Hypernatremia / epidemiology*
  • Intensive Care Units
  • Logistic Models
  • Male
  • Middle Aged
  • Multiple Organ Failure / epidemiology*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sepsis / epidemiology
  • Sepsis / mortality
  • Severity of Illness Index
  • Shock, Septic / epidemiology*
  • Shock, Septic / mortality