Increased Mortality in Elderly Patients Admitted with Hyponatremia: A Prospective Cohort Study

Hyponatremia is the most common electrolyte disorder, commonly affecting older hospitalized individuals; however, the literature is not clear regarding its effect on mortality. The aim of this 2-year observational prospective cohort study was to evaluate the mortality and re-admission rates, the clinical and laboratory characteristics and the causes of hyponatremia in patients older than 65 years admitted with a corrected serum sodium of 130 mEq/L or less in an internal medicine ward of a tertiary Greek university hospital. During the observation period, 138 patients (mean age 80.5 years, 36.2% male) fulfilled the inclusion criteria and were prospectively followed for 1 year after admission. Symptoms of hyponatremia were present in 59.4% of patients. Hypovolemia was the main sole cause of hyponatremia, but in about one third of patients, hyponatremia was multifactorial. Only a low proportion of patients (12.3%) fulfilled the criteria of the syndrome of inappropriate antidiuresis (SIAD) at admission according to the current guidelines. The re-admission rates at 3- and 12-months following discharge was 34.2% and 51.8%, respectively. Mortality during hospitalization was 17.4% and was higher compared to non-hyponatremic admitted older patients, while the total mortality at 1 year after admission was 28.3%, indicating that hyponatremia at admission is a marker of significant mortality during and after hospitalization in elderly patients.

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p2PSA for predicting biochemical recurrence of prostate cancer earlier than total prostate-specific antigen after radical prostatectomy: an observational prospective cohort study

Minerva Urologica e Nefrologica ◽

10.23736/s0393-2249.19.03279-x ◽

2019 ◽

Vol 71 (3) ◽

Cited By ~ 1

Author(s):

Paolo Casale ◽

Alberto Saita ◽

Massimo Lazzeri ◽

Giovanni Lughezzani ◽

Rodolfo Hurle ◽

...

Keyword(s):

Prostate Cancer ◽

Cohort Study ◽

Radical Prostatectomy ◽

Prostate Specific Antigen ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Biochemical Recurrence ◽

Specific Antigen ◽

Total Prostate Specific Antigen ◽

Observational Prospective Cohort Study

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Therapeutic drug monitoring (TDM) as a tool in the switch from infliximab innovator to biosimilar in rheumatic patients: results of a 12-month observational prospective cohort study

Clinical Rheumatology ◽

10.1007/s10067-017-3686-6 ◽

2017 ◽

Vol 36 (9) ◽

pp. 2129-2134 ◽

Cited By ~ 12

Author(s):

E. M. H. Schmitz ◽

S. Benoy - De Keuster ◽

A. J. L. Meier ◽

V. Scharnhorst ◽

R. A. M. Traksel ◽

...

Keyword(s):

Cohort Study ◽

Therapeutic Drug Monitoring ◽

Prospective Cohort Study ◽

Drug Monitoring ◽

Prospective Cohort ◽

Therapeutic Drug ◽

Observational Prospective Cohort Study ◽

Rheumatic Patients

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Prospective cohort study of risk factors for extended-spectrum ß-lactamase-producing Escherichia coli urinary tract infections in elderly patients admitted to hospital

International Journal of Clinical Practice ◽

10.1111/ijcp.13001 ◽

2017 ◽

Vol 71 (9) ◽

pp. e13001 ◽

Cited By ~ 7

Author(s):

Arturo Artero ◽

Ana Esparcia ◽

Juan Alberola ◽

Manuel Madrazo ◽

José M. Nogueira ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Cohort Study ◽

Urinary Tract ◽

Elderly Patients ◽

Urinary Tract Infections ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Extended Spectrum ◽

Tract Infections

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P0154BLOOD PRESSURE CONTROL IN ELDERLY PATIENTS WITH HEART FAILURE AND MORTALITY RISK: A POPULATION-BASED PROSPECTIVE COHORT STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0154 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Antonios Douros ◽

Alice Schneider ◽

Dörte Huscher ◽

Natalie Ebert ◽

Nina Mielke ◽

...

Keyword(s):

Heart Failure ◽

Cohort Study ◽

High Risk ◽

Elderly Patients ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Antihypertensive Drugs ◽

Population Based ◽

Vulnerable Population ◽

All Cause Mortality

Abstract Background and Aims Current guidelines on the management of heart failure (HF) recommend control of blood pressure (BP) in elderly patients. However, the exact treatment goals in this vulnerable population are unclear. Thus, our population-based prospective cohort study aimed to assess whether BP values <140/90 mmHg are associated with a decreased risk of cardiovascular (CV) death and all-cause mortality in HF patients ≥70 years. Method The study included participants of the Berlin Initiative Study (BIS), all ≥70 years, who were treated with antihypertensive drugs and had a diagnosis of HF (ICD-10 codes: I11.0, I13.0, I13.2, I50.x) at baseline. The study period was from 2009 to 2017. Demographics, lifestyle factors, medications, and comorbidities were assessed in face-to-face interviews and from linked administrative healthcare data. Outcomes were adjudicated using death certificates and hospital discharge notes. Cox proportional hazards models yielded crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of CV death and all-cause mortality associated with normalized BP (systolic BP <140 mmHg and diastolic BP <90 mmHg) compared with non-normalized BP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) in patients with HF. In sensitivity analyses we restricted to high-risk HF patients (≥80 years or with previous CV events). We also repeated the analyses in patients without HF to assess a potential effect modification. Results Among 1623 BIS participants treated with antihypertensive drugs at baseline, 544 (33.5%) had a diagnosis of HF. Of those, 255 (46.9%) showed normalized BP and 289 (53.1%) had non-normalized values. Mean age (standard deviation [SD]) was 82.8 (6.8) years (45.4% female). Selected patient characteristics are shown in the Table. Median (interquartile range) duration of follow-up was 6.7 (4.1-7.3) years. Compared with non-normalized BP, normalized BP was associated with a numerically increased risk of CV death (HR, 1.40; 95% CI, 0.90-2.17) and all-cause mortality (HR, 1.28; 95% CI, 0.96-1.71) in patients with HF. The associations were more pronounced or reached statistical significance when restricting to HF patients ≥80 years (CV death: HR, 1.54; 95% CI, 0.94-2.53 / all-cause mortality: HR, 1.56; 95% CI, 1.11-2.18) or HF patients with previous CV events (CV death: HR, 1.65; 95% CI, 0.83-3.29 / all-cause mortality: HR, 1.33; 95% CI, 0.85-2.07) (Figure). The effect estimates in patients without HF were comparable to those with HF (CV death: HR, 1.18; 95% CI, 0.78-1.78; p for interaction, 0.695 / all-cause mortality: HR, 1.20; 95% CI, 0.93-1.54; p for interaction, 0.604). Conclusion Our study suggests that normalized BP does not decrease the risk of CV death or all-cause mortality in elderly patients with HF and it could even increase the risk especially in high-risk subgroups. Thus, individualized benefit-risk assessment is required for the pharmacotherapy of HF in this vulnerable population.

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Indwelling urinary catheters, aortic valve treatment and delirium: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-021708 ◽

2018 ◽

Vol 8 (11) ◽

pp. e021708 ◽

Cited By ~ 2

Author(s):

Leslie SP Eide ◽

Anette H Ranhoff ◽

Sandra Lauck ◽

Bengt Fridlund ◽

Rune Haaverstad ◽

...

Keyword(s):

Cohort Study ◽

Aortic Valve ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Postoperative Delirium ◽

Primary Outcome ◽

University Hospital ◽

Transcatheter Aortic Valve ◽

The Difference ◽

Valve Implantation

ObjectivesTo determine whether an association exists between delirium and length of time indwelling urine catheters (IUC) are used in octogenarian patients treated with surgical aortic valve treatment (SAVR) or transcatheter aortic valve implantation (TAVI).DesignProspective cohort study.SettingTertiary university hospital covering the western region of Norway.ParticipantsOctogenarian patients undergoing elective SAVR or TAVI and willing to participate in the study were eligible. Patients unable to speak Norwegian were excluded. Between 2011 and 2013, 143 consecutive patients were included, and data from 136 of them are presented.Primary outcomeDelirium.ResultsLogistic regression analysis shows that lower cognitive function was positively associated with delirium (OR 0.86, CI 0.74 to 0.99, p=0.047). Besides, the interaction term in the model shows that IUC use and delirium differed between SAVR and TAVI patients (p=0.04). The difference corresponded to a weaker association between hours of IUC use and delirium for SAVR (OR 1.01, CI: 0.99 to 1.03, p=0.54) compared with that for TAVI (OR 1.04, CI: 1.01 to 1.08, p=0.004).ConclusionsThe association between IUC use and delirium is stronger for octogenarian patients treated with TAVI than for patients who received SAVR. Our results revealed a previously unknown association between the number of hours an IUC is used and postoperative delirium in octogenarian patients treated with TAVI.

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