Prevalence and clinical significance of serum sodium variability in patients with acute-on-chronic liver diseases: a prospective multicenter study in China

被引:5
作者
Mei, Xue [1 ]
Li, Hai [2 ,3 ]
Deng, Guohong [4 ]
Wang, Xianbo [5 ]
Zheng, Xin [6 ]
Huang, Yan [7 ]
Chen, Jinjun [8 ]
Meng, Zhongji [9 ]
Gao, Yanhang [10 ]
Liu, Feng [11 ]
Lu, Xiaobo [12 ]
Shi, Yu [13 ,14 ,15 ]
Zheng, Yubao [16 ]
Yan, Huadong [17 ]
Zhang, Weituo [18 ]
Qiao, Liang [2 ,3 ]
Gu, Wenyi [2 ,3 ]
Zhang, Yan [2 ,3 ]
Xiang, Xiaomei [4 ]
Zhou, Yi [4 ]
Sun, Shuning [4 ]
Hou, Yixin [5 ]
Zhang, Qun [5 ]
Xiong, Yan [6 ]
Zou, Congcong [6 ]
Chen, Jun [7 ]
Huang, Zebing [7 ]
Li, Beiling [8 ]
Jiang, Xiuhua [8 ]
Zhong, Guotao [8 ]
Wang, Haiyu [8 ]
Chen, Yuanyuan [9 ]
Luo, Sen [9 ]
Gao, Na [10 ]
Liu, Chunyan [10 ]
Li, Jing [11 ]
Li, Tao [11 ]
Zheng, Rongjiong [12 ]
Zhou, Xinyi [12 ]
Ren, Haotang [13 ,14 ,15 ]
Yuan, Wei [1 ]
Qian, Zhiping [1 ]
机构
[1] Fudan Univ, Shanghai Publ Hlth Clin Ctr, Dept Liver, Intens Care Unit, 2901 Cao Lang Rd, Shanghai 201508, Peoples R China
[2] Shanghai Jiao Tong Univ, Ren Ji Hosp, Sch Med, Dept Gastroenterol, Shanghai, Peoples R China
[3] Shanghai Jiao Tong Univ, Shanghai Inst Digest Dis, Key Lab Gastroenterol & Hepatol, Chinese Minist Hlth, Shanghai, Peoples R China
[4] Third Mil Med Univ, Army Med Univ, Southwest Hosp, Dept Infect Dis, Chongqing, Peoples R China
[5] Capital Med Univ, Beijing Ditan Hosp, Ctr Integrat Med, Beijing, Peoples R China
[6] Huazhong Univ Sci & Technol, Tongji Med Coll, Union Hosp, Dept Infect Dis Inst Infect & Immunol, Wuhan, Peoples R China
[7] Cent South Univ, Xiangya Hosp, Dept Infect Dis, Hunan Key Lab Viral Hepatitis, Changsha, Peoples R China
[8] Southern Med Univ, Nanfang Hosp, Dept Infect Dis, Hepatol Unit, Guangzhou, Peoples R China
[9] Hubei Univ Med, Taihe Hosp, Hubei Clin Res Ctr Precise Diag & Treatment Liver, Dept Infect Dis, Shiyan, Peoples R China
[10] First Hosp Jilin Univ, Dept Hepatol, Changchun, Peoples R China
[11] Shandong Univ, Dept Infect Dis & Hepatol, Hosp 2, Jinan, Peoples R China
[12] Xinjiang Med Univ, Infect Dis Ctr, Affiliated Hosp 1, Urumqi, Peoples R China
[13] Zhejiang Univ, Affiliated Hosp 1, Sch Med, State Key Lab Diag & Treatment Infect Dis, Hangzhou, Peoples R China
[14] Collaborat Innovat Ctr Diag & Treatment Infect Di, Hangzhou, Peoples R China
[15] Natl Clin Res Ctr Infect Dis, Hangzhou, Peoples R China
[16] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Infect Dis, Guangzhou, Peoples R China
[17] Number 2 Hosp, Dept Hepatol, Ningbo, Peoples R China
[18] Shanghai Jiao Tong Univ, Clin Res Inst, Sch Med, Shanghai, Peoples R China
关键词
Prevalence; Significance; Serum sodium; Na; Hyponatremia; Adverse outcome; 90-day; Prognosis; Acuteon-chronic liver disease; AoCLD; QUALITY-OF-LIFE; HYPONATREMIA; CIRRHOSIS; MORTALITY; MELD; TRANSPLANTATION; ALLOCATION; OUTCOMES; MODEL; RISK;
D O I
10.1007/s12072-021-10282-8
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background No reports exist regarding the prevalence of different Na levels and their relationship with 90-day prognosis in hospitalized patients with acute-on-chronic liver disease (AoCLD) in China. Therefore, the benefit of hyponatremia correction in AoCLD patients remains unclear. Methods We prospectively collected the data of 3970 patients with AoCLD from the CATCH-LIFE cohort in China. The prevalence of different Na levels (<= 120; 120-135; 135-145; > 145) and their relationship with 90-day prognosis were analyzed. For hyponatremic patients, we measured Na levels on days 4 and 7 and compared their characteristics, based on whether hyponatremia was corrected. Results A total of 3880 patients were involved; 712 of those developed adverse outcomes within 90 days. There were 80 (2.06%) hypernatremic, 28 (0.72%) severe hyponatremic, and 813 (20.95%) mild hyponatremic patients at admission. After adjusting for all confounding factors, the risk of 90-day adverse outcomes decreased by 5% (odds ratio [OR] 0.95; 95% confidence interval [CI] 0.93-0.97; p < 0.001), 24% (OR 0.76; 95% CI 0.70-0.84; p< 0.001), and 42% (OR 0.58; 95% CI 0.49-0.70; p < 0.001) as Na level increased by 1, 5, and 10 mmol/L, respectively. Noncorrection of hyponatremia on days 4 and 7 was associated with 2.05-fold (hazard ratio [HR], 2.05; 95% CI, 1.50-2.79; p < 0.001) and 1.46-fold (HR 1.46; 95% CI 1.05-2.02; p= 0.028) higher risk of adverse outcomes. Conclusions Hyponatremia was an independent risk factor for a poor 90-day prognosis in patients with AoCLD. Failure to correct hyponatremia in a week after admission was often associated with increased mortality.
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收藏
页码:183 / 194
页数:12
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