Impact of Hyponatremia on COPD Exacerbation Prognosis
Impact of Hyponatremia on COPD Exacerbation Prognosis
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DOI：
10.3390/jcm9020503
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发表时间：
2020-02-01
影响因子：
3.9
通讯作者：
Gonzalez-Barcala, Francisco-Javier
中科院分区：
文献类型：
--
作者：
Garcia-Sanz, Maria-Teresa;Martinez-Gestoso, Sandra;Gonzalez-Barcala, Francisco-Javier
低钠血症是住院患者中最常见的电解质紊乱，是各种疾病预后不良的预测指标。本研究的目的是确定慢性阻塞性肺疾病急性加重期(AECOPD)住院患者低钠血症的患病率及其与临床进展不佳的关系。2016年10月1日至2018年10月1日在以下医院进行了前瞻性观察研究：比拉加西亚·德·阿鲁萨的Salnes医院、费罗尔的Arquitecto Marish医院和西班牙加利西亚圣地亚哥·德·孔波斯特拉大学医院建筑群，研究对象是AECOPD住院患者。确定患者的基线治疗，包括导致低钠血症的药物。进展差的定义为：长时间住院、住院期间死亡或在指标发作出院后一个月内再次入院。低钠血症65例(10.8%)，均为轻度低钠血症(平均131.6例，SD2.67)。在所有患者中，362名(60%)进展不佳：18名(3%)在入院时死亡；327名(54.3%)长期住院；91名(15.1%)在出院后一个月内再次入院。低钠血症患者有更多的房颤(P<0.005)、胸腔积液(P<0.01)和住院时间延长(P<0.01)。与进展不佳独立相关的因素是低钠血症、肺炎和入院前未接受家庭氧气治疗。低钠血症在AECOPD住院患者中相对常见，它具有重要的预后意义，即使本质上是轻微的。
The most common electrolyte disorder among hospitalized patients, hyponatremia is a predictor of poor prognosis in various diseases. The aim of this study was to establish the prevalence of hyponatremia in patients admitted for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), as well as its association with poor clinical progress. Prospective observational study carried out from 1 October 2016 to 1 October 2018 in the following hospitals: Salnes in Vilagarcia de Arousa, Arquitecto Marcide in Ferrol, and the University Hospital Complex of Santiago de Compostela, Galicia, Spain, on patients admitted for AECOPD. Patient baseline treatment was identified, including hyponatremia-inducing drugs. Poor progress was defined as follows: prolonged stay, death during hospitalization, or readmission within one month after the index episode discharge. 602 patients were enrolled, 65 cases of hyponatremia (10.8%) were recorded, all of a mild nature (mean 131.6; SD 2.67). Of all the patients, 362 (60%) showed poor progress: 18 (3%) died at admission; 327 (54.3%) had a prolonged stay; and 91 (15.1%) were readmitted within one month after discharge. Patients with hyponatremia had a more frequent history of atrial fibrillation (AF) (p 0.005), pleural effusion (p 0.01), and prolonged stay (p 0.01). The factors independently associated with poor progress were hyponatremia, pneumonia, and not receiving home O-2 treatment prior to admission. Hyponatremia is relatively frequent in patients admitted for AECOPD, and it has important prognostic implications, even when mild in nature.