Muller M, et al. - Researchers intended to ascertain if hyponatraemia on Emergency Department (ED) admission independently affected the in-hospital mortality, ICU admission, and/or length of hospitalisation in patients with pneumonia identified by retrospective screening of electronic admission data. Findings disclosed that poor outcome was speculated via hyponatraemia on admission. It served as an independent risk factor for in-hospital mortality in admitted patients diagnosed with pneumonia.

Methods

• Using, retrospective screening of electronic admission data (06/2011-06/2013), 610 patients (64.4% male, median 66 years) diagnosed with pneumonia were selected.
• Patients were admitted to the ED of Bern University Hospital, Switzerland.
• A scrutiny was conducted of the patient characteristics, potential confounders, and patient-centred clinical outcomes, including mortality, ICU admission, and length of hospitalisation.
• Using multivariate logistic analysis adjusted for typical confounders, the association of hyponatraemia with clinical outcomes was examined.

Results

• The overall in-hospital mortality rate in a large cohort of consecutive acutely admitted patients with pneumonia was 12.5%; 21.2% of patients required primary or secondary ICU admission, and the median length of hospital stay was 8 (IQR 5-13) days.
• At baseline, 47 patients (7.7%) presented with concomitant hyponatraemia.
• As per the multivariate regression, a prominent link was displayed between hyponatraemia and in-hospital mortality (adjusted OR: 2.7, 95% CI: 1.3-5.9, p=0.010).
• This was not noted with ICU admission (adjusted OR: 1.8, 95% CI: 0.9-3.6, p=0.103) or length of hospitalisation (p=0.493) after adjustment for age, neoplasia, COPD, suspected sepsis, and cardiac disease.
• It was noted that the correlation was regarded as robust if controlled for other covariates, eg CRB-65 score.