PREDICTIVE VALUE OF RENAL INSUFFICIENCY IN CLINICAL OUTCOMES IN HOSPITALIZED HYPONATREMIC PATIENTS WITH SYSTOLIC HEART FAILURE: THE CLINICAL CHARACTERISTICS ANDOUTCOMES IN RELATION WITH SERUM SODIUM LEVEL IN ASIAN PATIENTS HOSPITALIZED OR HEART FAILURE (THE COAST) STUDY

Abstract Background The association of lower serum sodium levels with clinical outcomes in insomnia patients remains unclear. We explored whether lower serum sodium is associated with poor clinical outcomes in patients with insomnia. Methods We retrospectively enrolled patients with a diagnosis of insomnia from January 2011 to December 2012. We divided participants into three groups according to initial serum sodium level: tertile 1 (< 138 mmol/L), tertile 2 (138.0–140.9 mmol/L), and tertile 3 (≥ 141.0 mmol/L). To calculate the relative risk of death, hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained using Cox proportional hazard models. Result A total of 412 patients with insomnia were included, of whom 13.6% (n = 56) had hyponatremia. Patients with lower serum sodium concentrations were older and had lower hemoglobin, calcium, phosphorus, and albumin levels. At the median follow-up of 49.4 months, 44 patients had died and 62 experienced acute kidney injury (AKI). Kaplan-Meier analysis showed significantly higher mortality in patients in the lowest tertile for serum sodium. Lowest tertile of serum sodium, AKI, and chronic respiratory disease were associated with all-cause mortality. In addition, lowest tertile of serum sodium was also significantly associated with AKI. Conclusions The lowest tertile of serum sodium was associated with a higher mortality and AKI rate in insomnia patients. Our results suggest serum sodium level could be used one of the prognostic factor in insomniacs and physicians should be careful to take care of them when they present lower sodium level.

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Lower serum sodium level predicts poor clinical outcomes in patients with insomnia

10.21203/rs.3.rs-26525/v2 ◽

2020 ◽

Author(s):

Eunjin Bae ◽

Tae Won Lee ◽

Ha Nee Jang ◽

Hyun Seop Cho ◽

Sehyun Jung ◽

...

Keyword(s):

Clinical Outcomes ◽

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

Kidney Injury ◽

Lower Serum ◽

Risk Of Death ◽

Kaplan Meier ◽

Hazard Ratios ◽

Calcium Phosphorus

Abstract Background The association of lower serum sodium levels with clinical outcomes in insomnia patients remains unclear. We explored whether lower serum sodium is associated with poor clinical outcomes in patients with insomnia. Methods We retrospectively enrolled patients with a diagnosis of insomnia from January 2011 to December 2012. We divided participants into three groups according to initial serum sodium level: tertile 1 (< 138 mmol/L), tertile 2 (138.0–140.9 mmol/L), and tertile 3 (≥ 141.0 mmol/L). To calculate the relative risk of death, hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained using Cox proportional hazard models. Result A total of 412 patients with insomnia were included, of whom 13.6% (n = 56) had hyponatremia. Patients with lower serum sodium concentrations were older and had lower hemoglobin, calcium, phosphorus, and albumin levels. At the median follow-up of 49.4 months, 44 patients had died and 62 experienced acute kidney injury (AKI). Kaplan-Meier analysis showed significantly higher mortality in patients in the lowest tertile for serum sodium. Lowest tertile of serum sodium, and AKI were associated with all-cause mortality. However, lowest tertile of serum sodium was not significantly associated with AKI. Conclusions The lowest tertile of serum sodium was associated with a higher mortality rate in insomnia patients. Our results suggest serum sodium level could be used one of the prognostic factor in insomniacs and physicians should be careful to take care of them when they present lower sodium level.

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Abstract 15161: Impact of Malnutrition Score Index on Short-term Clinical Outcome in Patients with Acute Decompensated Heart Failure

Circulation ◽

10.1161/circ.130.suppl_2.15161 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Naotsugu Iwakami ◽

Toshiyuki Nagai ◽

Yasuo Sugano ◽

Takafumi Yamane ◽

Tatsuhiro Shibata ◽

...

Keyword(s):

Heart Failure ◽

Adverse Events ◽

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Hospital Death ◽

Short Term ◽

Conut Score

Backgrounds: Recent studies have elucidated the association between malnutrition and poor long-term prognosis in patients with chronic heart failure (HF), using controlling nutritional status (CONUT) score, a simple and useful index for evaluating malnutrition. In this study, we aim to investigate the prognostic significance of CONUT score in patients with acute decompensated HF. Methods: We examined 320 consecutive patients in our prospective acute decompensated HF registry database from January 2013 to January 2014. Patients with acute coronary syndrome, in-hospital death, and without complete data-set at discharge were excluded. Finally, we selected 206 patients as a study population and malnutrition was defined as CONUT score above 3 at discharge. Results: 112 (54%) patients showed malnutrition at discharge. Patients with malnutrition had higher age, serum creatinine and plasma brain natriuretic peptide levels, and lower serum sodium level at discharge than those without. There were no significant differences between the groups in terms of sex, blood pressure, heart rate, left ventricular ejection fraction, etiology of HF and cardiovascular medications at discharge. During the median follow-up of 192 days (interquartile range = 109-260 days), malnutrition was associated with higher short-term adverse events including death and HF admission (P = 0.008, Figure). Cox proportional-hazards model analysis demonstrated that malnutrition was independently associated with adverse events (HR 2.00, 95% CI 1.01-4.17, P = 0.047), even after adjustment among variables including age (HR 1.04, 95% CI 1.00-1.08, P = 0.03) and serum sodium level (HR 0.93, 95% CI 0.88-1.00, P = 0.04). Conclusions: In patients with acute decompensated HF, malnutrition at discharge was independently associated with worse short-term clinical outcomes. These findings suggest that earlier intensive nutrition management might need to be considered.

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Relation of Serum Sodium Level to Long-Term Outcome After a First Hospitalization for Heart Failure With Preserved Ejection Fraction

The American Journal of Cardiology ◽

10.1016/j.amjcard.2008.09.091 ◽

2009 ◽

Vol 103 (3) ◽

pp. 405-410 ◽

Cited By ~ 40

Author(s):

Dan Rusinaru ◽

Otilia Buiciuc ◽

Laurent Leborgne ◽

Michel Slama ◽

Ziad Massy ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

Preserved Ejection Fraction ◽

Term Outcome ◽

Long Term Outcome

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Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure

Nutrients ◽

10.3390/nu12113311 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3311

Author(s):

Sayaki Ishiwata ◽

Shoichiro Yatsu ◽

Takatoshi Kasai ◽

Akihiro Sato ◽

Hiroki Matsumoto ◽

...

Keyword(s):

Heart Failure ◽

Body Weight ◽

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Nutritional Index ◽

All Cause Mortality

The TCB index (triglycerides × total cholesterol × body weight), a novel simply calculated nutritional index based on serum triglycerides (TGs), serum total cholesterol (TC), and body weight (BW), was recently reported to be a useful prognostic indicator in patients with coronary artery disease. Thus, this study aimed to investigate the relationship between TCBI and long-term mortality in acute decompensated heart failure (ADHF) patients. Patients with a diagnosis of ADHF who were consecutively admitted to the cardiac intensive care unit in our institution from 2007 to 2011 were targeted. TCBI was calculated using the formula TG (mg/dL) × TC (mg/dL) × BW (kg)/1000. Patients were divided into two groups according to the median TCBI value. An association between admission TCBI and mortality was assessed using univariable and multivariable Cox proportional hazard analyses. Overall, 417 eligible patients were enrolled, and 94 (22.5%) patients died during a median follow-up period of 2.2 years. The cumulative survival rate with respect to all-cause, cardiovascular, and cancer-related mortalities was worse in patients with low TCBI than in those with high TCBI. In the multivariable analysis, although TCBI was not associated with cardiovascular and cancer mortalities, the association between TCBI and reduced all-cause mortality (hazard ratio: 0.64, 95% confidence interval: 0.44–0.94, p = 0.024) was observed. We computed net reclassification improvement (NRI) when TCBI or Geriatric Nutritional Risk Index (GNRI) was added on established predictors such as hemoglobin, serum sodium level, and both. TCBI improved discrimination for all-cause mortality (NRI: 0.42, p < 0.001; when added on hemoglobin and serum sodium level). GNRI can improve discrimination for cancer mortality (NRI: 0.96, p = 0.002; when added on hemoglobin and serum sodium level). TCBI, a novel and simply calculated nutritional index, can be useful to stratify patients with ADHF who were at risk for worse long-term overall mortality.

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