Increased mortality risk associated with serum sodium variations and borderline hypo- and hypernatremia in hospitalized adults

Abstract Background This study aimed to evaluate short-term and long-term mortalities in a cohort of unselected hospitalized patients with serum sodium concentration ([Na+]) variations within and outside of reference range. Methods All adult patients admitted to the Mayo Clinic, Rochester, MN, USA from January 2011 to December 2013 (n = 147358) were retrospectively screened. Unique patients admitted during the study period were examined. The main exposure was serum [Na+] variation. Outcome measures were hospital and 1-year all-cause mortalities. Results A total of 60944 patients, mean age 63 ± 17 years, were studied. On admission, 17% (n = 10066) and 1.4% (n = 852) had hypo- and hypernatremia, respectively. During the hospital stay, 11044 and 4128 developed hypo- and hypernatremia, respectively, accounting for 52.3 and 82.9% of the total hypo- and hypernatremic patients. Serum [Na+] variations of ≥6 mEq/L occurred in 40.6% (n = 24 740) of the 60 944 patients and were significantly associated with hospital and 1-year mortalities after adjusting potential confounders (including demographics, comorbidities, estimated glomerular filtration rate, admission serum [Na+], number of [Na+] measurements and length of hospital stay). Adjusted odds ratios for hospital and 1-year mortalities increased with increasing [Na+] variations in a dose-dependent manner, from 1.47 to 5.48 (all 95% confidence intervals >1.0). Moreover, in fully adjusted models, [Na+] variations (≥6 mEq/L) within the reference range (135–145 mEq/L) or borderline hypo- or hypernatremia (133–137 and 143–147 mEq/L, respectively) compared with 138–142 mEq/L were associated with increased hospital and 1-year mortalities. Conclusion In hospitalized adults, [Na+] fluctuation (≥6 mEq/L) irrespective of admission [Na+] and borderline hypo- or hypernatremia are independent predictors of progressively increasing short- and long-term mortality burdens.

Download Full-text

Fluctuation of Serum Sodium and Its Impact on Short and Long-Term Mortality following Acute Pulmonary Embolism

PLoS ONE ◽

10.1371/journal.pone.0061966 ◽

2013 ◽

Vol 8 (4) ◽

pp. e61966 ◽

Cited By ~ 11

Author(s):

Austin Chin Chwan Ng ◽

Vincent Chow ◽

Andy Sze Chiang Yong ◽

Tommy Chung ◽

Leonard Kritharides

Keyword(s):

Pulmonary Embolism ◽

Serum Sodium ◽

Acute Pulmonary Embolism ◽

Short And Long Term ◽

Long Term Mortality

Download Full-text

Impacts of admission serum albumin levels on short-term and long-term mortality in hospitalized patients

QJM ◽

10.1093/qjmed/hcz305 ◽

2019 ◽

Vol 113 (6) ◽

pp. 393-398 ◽

Cited By ~ 2

Author(s):

C Thongprayoon ◽

W Cheungpasitporn ◽

A Chewcharat ◽

M A Mao ◽

S Thirunavukkarasu ◽

...

Keyword(s):

Hospital Mortality ◽

Serum Albumin ◽

Hospital Stay ◽

Reference Group ◽

Albumin Level ◽

Hospitalized Patients ◽

Tertiary Referral Hospital ◽

Short And Long Term ◽

Long Term Mortality

Abstract Aim The aim of this study is to assess the association between admission serum albumin and short- and long-term mortality in all hospitalized patients. Design A single-center cohort study. Methods A retrospective cohort of all adult hospitalized patients at a tertiary referral hospital between January 2009 and December 2013 were analysed. Admission serum albumin was stratified into six groups: ≤2.4, 2.5–2.9, 3.0–3.4, 3.5–3.9, 4.0–4.4 and ≥4.5 g/dl. The outcomes of interest were in-hospital mortality, length of hospital stay and 1-year mortality. Serum albumin of 4–4.4 g/dl was selected as a reference group for outcome comparison. Results A total of 14 075 patients were studied. Admission serum albumin of ≥4.5 g/dl had the lowest in-hospital and 1-year mortality with progressively increased in-hospital mortality observed with decreased admission serum albumin. In adjusted analysis, compared with serum albumin of 4.0–4.4 g/dl, serum albumin of ≤2.4, 2.5–2.9, 3.0–3.4 and 3.5–3.9 were significantly associated with increased in-hospital and 1-year mortality. In contrast, serum albumin of ≥4.5 g/dl was significantly associated with lower 1-year mortality but not in-hospital mortality. Admission serum albumin <4.0 g/dl was significantly associated with a prolonged hospital stay, while admission serum albumin of ≥4.5 g/dl was significantly associated with shorter hospital stay, compared with serum albumin of 4.0–4.4 g/dl. Conclusion Low albumin level at admission was progressively associated with increased short- and long-term mortality in all hospitalized patients even when albumin level was considered in normal range.

Download Full-text

Disruption of fish gut microbiota composition and holobiont’s metabolome by cyanobacterial blooms

10.1101/2021.09.08.459397 ◽

2021 ◽

Author(s):

Alison Gallet ◽

Sébastien Halary ◽

Charlotte Duval ◽

Hélène Huet ◽

Sébastien Duperron ◽

...

Keyword(s):

Oxygen Depletion ◽

Cyanobacterial Blooms ◽

Dependent Manner ◽

Microbiome Composition ◽

Fish Gut ◽

Short And Long Term ◽

Metabolome Profiling ◽

The Times ◽

Dose Dependent

AbstractBackgroundCyanobacterial blooms are one of the most common stress encountered by metazoans living in freshwater lentic systems such as lakes and ponds. Blooms reportedly impair fish health, notably through oxygen depletion and production of bioactive compounds including cyanotoxins. However, in the times of the “microbiome revolution”, it is surprising that so little is still known regarding the influence of blooms on fish microbiota. In this study, an experimental approach is used to demonstrate that blooms affect fish microbiome composition and functions, as well as the metabolome of holobionts. To this end, the model teleost Oryzias latipes is exposed to simulated Microcystis aeruginosa blooms of various intensities in a microcosm setting, and the response of bacterial gut communities is evaluated in terms of composition, metagenome-encoded functions and metabolome profiling.ResultsThe gut bacterial community of O. latipes exhibits marked responses to the presence of M. aeruginosa blooms in a dose-dependent manner. Notably, abundant gut-associated Firmicutes almost disappear, while potential opportunists increase. The holobiont’s gut metabolome displays major changes, while functions encoded in the metagenome of bacterial partners are more marginally affected. Bacterial communities tend to return to original composition after the end of the bloom suggesting post-bloom resilience, and remain sensitive in case of a second bloom, reflecting a highly reactive gut community.ConclusionIn the context of increasingly frequent and intense blooms worldwide, results point to the relevance of accounting for short- and long-term microbiome-related effects in fish ecology, with potential outcomes relevant to conservation biology as well as aquaculture.

Download Full-text

Admission blood lactate levels of patients diagnosed with cerebrovascular disease effects on short and long‐term mortality risk

International Journal of Clinical Practice ◽

10.1111/ijcp.14161 ◽

2021 ◽

Author(s):

Cemalettin Sakal ◽

Rohat AK ◽

Abdullah Taşçı ◽

Ecem Deniz Kırkpantur ◽

Ebru Ünal Akoğlu ◽

...

Keyword(s):

Cerebrovascular Disease ◽

Blood Lactate ◽

Mortality Risk ◽

Short And Long Term ◽

Lactate Levels ◽

Blood Lactate Levels ◽

Long Term Mortality

Download Full-text

Pre-operative atrial fibrillation is independently associated with short and long-term mortality after aortic valve replacement

Heart Lung and Circulation ◽

10.1016/j.hlc.2014.04.155 ◽

2014 ◽

Vol 23 ◽

pp. e11

Author(s):

T. Wang ◽

D. Choi ◽

T. Ramanathan ◽

P. Ruygrok

Keyword(s):

Atrial Fibrillation ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Short And Long Term ◽

Long Term Mortality

Download Full-text

Improved but still high short- and long-term mortality rates after myocardial infarction in patients with diabetes mellitus: a time-trend report from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admission

Heart ◽

10.1136/hrt.2006.097956 ◽

2006 ◽

Vol 93 (12) ◽

pp. 1577-1583 ◽

Cited By ~ 95

Author(s):

A. Norhammar ◽

J. Lindback ◽

L. Ryden ◽

L. Wallentin ◽

U. Stenestrand ◽

...

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Intensive Care ◽

Time Trend ◽

Mortality Rates ◽

Intensive Care Admission ◽

Patients With Diabetes ◽

Short And Long Term ◽

Long Term Mortality

Download Full-text

A dual approach to self-stimulation and locomotor trace affected by chronic methamphetamine treatment for an animal model of schizophrenia

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y93-050 ◽

1993 ◽

Vol 71 (5-6) ◽

pp. 321-325 ◽

Cited By ~ 11

Author(s):

Morikuni Takigawa ◽

Hiroshi Maeda ◽

Kenichi Ueyama ◽

Hidefumi Tominaga ◽

Kei Matsumoto

Keyword(s):

Animal Model ◽

Negative Symptoms ◽

Disease Model ◽

Stereotyped Behavior ◽

Dependent Manner ◽

Dual Approach ◽

Reverse Tolerance ◽

Self Stimulation ◽

Dose Dependent

The effect of long-term methamphetamine (MAP) treatment on intracranial self-stimulation of the lateral hypotholamus and locomotor traces was assessed. An attempt was made to provide a useful animal model for understanding anhedonia, stereotypy, and reoccurrence of liability, which are analogous to symptoms of schizophrenia. The frequency of intracranial self-stimulation (ICSS) as used as a measure of the animals' "hedonic–anhedonic" state. Following long-term MAP treatment (3 mg/kg), rats gradually showed stereotyped behavior, and became inactive and unresponsive to ICSS. These behavioral changes and decreased ICSS lasted several weeks after cessation of chronic MAP treatment and seemed to suggest post-MAP chronic psychosis and (or) anhedonia, two of the negative symptoms of schizophrenia. The traces of rat behavior affected by chronic MAP treatment were classified into three types, peripheral, mixed, and fixed, occurring in a dose-dependent manner. Reverse tolerance, similar to the reoccurrence of schizophrenic symptoms, was observed as a fixed stereotypy associated with loss of ICSS. These abnormal phenomena were suppressed by pretreatment with haloperidol. In the present study, the combination of ICSS and locomotor trace affected by chronic MAP treatment was proposed as an animal model of schizophrenia and as a useful technique for gauging the effect of neuroleptics.Key words: self-stimulation, anhedonia, stereotypy, reverse tolerance, animal disease model, schizophrenia, methamphetamine.

Download Full-text