+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Prognostic value of ICU-acquired hypernatremia in patients with neurological dysfunction



Prognostic value of ICU-acquired hypernatremia in patients with neurological dysfunction



Medicine 95(35): E3840



Many studies have indicated that hypernatremia is associated with increased mortality. In this study, we aimed to explore the relationship between intensive care unit (ICU)-acquired hypernatremia and the prognosis of critically neurological patients.Based on serum sodium level in the ICU, 450 patients were divided into 3 groups: 222 had normal serum sodium, 142 had mild hypernatremia, and 86 had severe hypernatremia. Kaplan-Meier and multivariable binary logistic regression analyses were performed to evaluate the prognostic value of hypernatremia in critically neurological patients. Receiver operating characteristic (ROC) curve was constructed for serum sodium levels to determine their roles in predicting ICU mortality.Hypernatremia was significantly related with age, Glasgow Coma Scale (GCS) score, serum sodium, APACHE II score, and serum creatinine. Moreover, the different treatment outcome including mechanical ventilation, the days of stayed in ICU, and Glasgow Outcome Scale score had correlation with serum sodium levels. Old ages, GCS score, therapeutic intervention scoring system (TISS) score, APACHE II score, serum sodium peak, and so on were all associated with the mortality. In addition, hypernatremia was an independent prognostic factor for critically neurological patients by logistic regression analysis (odds ratio = 1.192, 95% confidence interval = 1.135-1.252, P = 0.000). Moreover, we got the sensitivity of 79.4% and specificity of 74.5% in the ROC analysis between peak serum sodium and the mortality. The area under the ROC curve was 0.844, and the optimal cutoff value was 147.55.Our results showed that ICU-acquired hypernatremia may be a potential prognosis marker for critically neurological patients.

(PDF emailed within 0-6 h: $19.90)

Accession: 058637525

Download citation: RISBibTeXText

PMID: 27583842

DOI: 10.1097/MD.0000000000003840


Related references

Increased mortality in geriatric patients with hospital-acquired hypernatremia. American Journal of Medicine 126(6): E13-E14, 2013

Tonicity balance in patients with hypernatremia acquired in the intensive care unit. American Journal of Kidney Diseases 54(4): 674-679, 2009

Prognostic significance of hypernatremia and hyponatremia among patients with aneurysmal subarachnoid hemorrhage. Neurosurgery 50(4): 749-55; Discussion 755-6, 2002

Prognostic significance of hypernatremia and hyponatremia in patients with aneurysmal subarachnoid hemorrhage. Neurology 56(8 Supplement 3): A469, April 24, 2001

Myelopathy as initial neurological dysfunction of the acquired immune deficiency syndrome. Neurobiologia (Recife) 54(4): 177-180, 1991

Early intensive care unit-acquired hypernatremia in severe sepsis patients receiving 0.9% saline fluid resuscitation. Acta Anaesthesiologica Scandinavica 58(8): 1007-1014, 2015

Risk factors for hospital-acquired hypernatremia among critically ill medical patients in a setting utilizing a preventive free water protocol: Do we need to do more?. Indian Journal of Critical Care Medicine 17(1): 28-33, 2013

Community-acquired hypernatremia in elderly and very elderly patients admitted to the hospital: clinical characteristics and outcomes. Medical Science Monitor 18(12): Cr729-Cr734, 2013

Prognostic value of transthoracic echocardiography and biomarkers of cardiac dysfunction in community-acquired pneumonia. Clinical Microbiology and Infection 22(12): 1006.E1-1006.E6, 2016

Computed tomography perfusion prognostic maps do not predict reversible and irreversible neurological dysfunction following reperfusion therapies. International Journal of Stroke 6(6): 544-546, 2012

Community-based rehabilitation and outpatient care for patients with acquired brain injury and chronic neurological disability in Germany: continuing support for social participation and re-integration in the neurological care system?. Die Rehabilitation 51(6): 424-430, 2013

Hypernatremia and neurological complications in rotavirus gastroenteritis. Ugeskrift for Laeger 167(4): 409-410, 2005

Prognostic value of right ventricular dysfunction and derivation of a prognostic model for patients with acute pulmonary thromboembolism. Zhonghua Liu Xing Bing Xue Za Zhi 30(2): 184-188, 2009

Behavioural induced severe hypernatremia without neurological manifestations. Saudi Journal of Kidney Diseases and Transplantation 21(1): 113-117, 2010

Hypernatremia predicts adverse cardiovascular and neurological outcomes after SAH. Neurocritical Care 5(3): 180-185, 2007