TITLE

Intensive care-acquired hypernatremia after major cardiothoracic surgery is associated with increased mortality

AUTHOR(S)
Lindner, Gregor; Funk, Georg-Christian; Lassnigg, Andrea; Mouhieddine, Mohamed; Ahmad, Salem-Ahmed; Schwarz, Christoph; Hiesmayr, Michael
PUB. DATE
October 2010
SOURCE
Intensive Care Medicine;Oct2010, Vol. 36 Issue 10, p1718
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: Hypernatremia is common in the medical Intensive Care Unit (ICU) and has been described as an independent risk factor for mortality. Hypernatremia has not yet been studied in a collection of ICU patients after cardiothoracic surgery. Therefore, we wanted to determine the incidence of hypernatremia in a surgical ICU and its association with outcomes of critically ill surgical patients. Methods: In this retrospective cohort study performed at a surgical ICU of a university hospital in Vienna, patients were admitted to the ICU after major cardiothoracic surgery between May 1999 and October 2007. Data on serum sodium in the ICU, ICU mortality, hospital mortality, and length of ICU stay were collected prospectively. Results: 2,699 patients underwent surgery during the study period, and 2,314 patients were included in the study. Two hundred twenty-one (10%) patients acquired hypernatremia during their ICU stay. Median onset of hypernatremia was on day 4 (2-7). Patients with ICU-acquired hypernatremia had a higher ICU mortality (19%) compared to patients without hypernatremia (8%; p < 0.01). Length of ICU stay was increased in patients with hypernatremia (17 vs. 3 days; p < 0.01). In a multivariate Cox regression, ICU-acquired hypernatremia was an independent risk factor for ICU mortality within 28 days. Conclusions: Hypernatremia is a common event early in the course of critical illness after major cardiothoracic surgery and is independently associated with ICU mortality within 28 days. Future research should focus on the impact of hypernatremia on physiological functions as well as adequate and safe treatment of the electrolyte disorder.
ACCESSION #
53703433

 

Related Articles

  • Epidemiology of Mechanical Ventilation: Analysis of the SAPS 3 Database. Metnitz, Philipp; Metnitz, Barbara; Moreno, Rui; Bauer, Peter; Sorbo, Lorenzo; Hoermann, Christoph; Carvalho, Susana; Marco Ranieri, V. // Intensive Care Medicine;May2009, Vol. 35 Issue 5, p816 

    To evaluate current practice of mechanical ventilation in the ICU and the characteristics and outcomes of patients receiving it. Pre-planned sub-study of a multicenter, multinational cohort study (SAPS 3). 13,322 patients admitted to 299 intensive care units (ICUs) from 35 countries. None....

  • Obstetric intensive care unit admission: a 2-year nationwide population-based cohort study. Zwart, Joost J.; Dupuis, Just R. O.; Richters, Annemiek; Öry, Ferko; van Roosmalen, Jos // Intensive Care Medicine;Feb2010, Vol. 36 Issue 2, p256 

    As part of a larger nationwide enquiry into severe maternal morbidity, our aim was to assess the incidence and possible risk factors of obstetric intensive care unit (ICU) admission in the Netherlands. In a 2-year nationwide prospective population-based cohort study, all ICU admissions during...

  • Baseline thrombospondin-1 concentrations are not associated with mortality in septic patients: a single-center cohort study on the intensive care unit. van der Wekken, Ruben; Kemperman, Hans; Roest, Mark; de Lange, Dylan // Intensive Care Medicine Experimental;1/25/2017, Vol. 5 Issue 1, p1 

    Background: The initial phase of sepsis is characterized by hyperinflammation. Levels of thrombospondin-1 (TSP-1) rise rapidly during acute inflammation. The purpose of this clinical study was to study the association between plasma TSP-1 levels and mortality in patients with sepsis on the...

  • Anne Sütü ile Yetersiz Beslenen YenidoÄŸanlarda Hipernatremik Dehidratasyon. Berk, Erhan; İçağasıoğlu, Dilara; Büyükkayhan, Derya; Gültekin, Asım; Cevit, Ömer // Erciyes Medical Journal / Erciyes Tip Dergisi;2010, Vol. 32 Issue 1, p5 

    Purpose: Breast-feeding is the best and safest way to feed infants. However, inadequate breastfeeding may result in hypernatremic dehydration and serious neurological complications in neonates. The aim of the present paper was to define the incidence, complications, morbidity and mortality of...

  • Prediction of Pediatric Mortality in Bahrami Children's Hospital Pediatric Intensive Care Unit (PICU) based on Pediatric Index of Mortality-2 (PIM2). Salamati, Payman; Zargar, Mousa; Eghbalkhah, Asgar; Chaman, Reza; Sotoudeh, Kambiz; Navabi, Behdad; Mokhtari, Zahra // Journal of Isfahan Medical School;May2010, Vol. 28 Issue 105, p1 

    Background: This study assessed to study Pediatric Index of Mortality-2 (PIM2) measure for outcome assessment of children admitted to pediatric intensive care unit (PICU) of Bahrami children's hospital. Methods: A prospective cohort study was implemented in Bahrami Children's Hospital affiliated...

  • Fantoms. Platt, Martin Ward // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Feb2009, Vol. 94 Issue 2, pF79 

    An introduction to the journal is presented in which the editor discusses various reports published within the issue, including the application of structured random safety audits to the neonatal intensive care unit (NICU) setting, extracorporeal membrane oxygenation (ECMO) outcomes in Great...

  • Lower short- and long-term mortality associated with overweight and obesity in a large cohort study of adult intensive care unit patients. Abhyankar, Swapna; Leishear, Kira; Callaghan, Fiona M.; Demner-Fushman, Dina; McDonald, Clement J. // Critical Care;2012, Vol. 16 Issue 6, p1 

    Introduction: Two thirds of United States adults are overweight or obese, which puts them at higher risk of developing chronic diseases and of death compared with normal-weight individuals. However, recent studies have found that overweight and obesity by themselves may be protective in some...

  • Case-mix-adjusted length of stay and mortality in 23 Finnish ICUs. Niskanen, Minna; Reinikainen, Matti; Pettilä, Ville // Intensive Care Medicine;Jun2009, Vol. 35 Issue 6, p1060 

    To create a tool for benchmarking intensive care units (ICUs) with respect to case-mix adjusted length of stay (LOS) and to study the association between clinical and economic measures of ICU performance. Observational cohort study. Twenty-three ICUs in Finland. A total of 80,854 consecutive ICU...

  • The effects of ICU admission and discharge times on mortality in Finland. Uusaro, Ari; Kari, Aarno; Ruokonen, Esko // Intensive Care Medicine;Dec2003, Vol. 29 Issue 12, p2144 

    Objective: Hospital mortality increases if acutely ill patients are admitted to hospitals on weekends as compared with weekdays. Night discharges may increase mortality in intensive care unit (ICU) patients but the effect of ICU admission time on mortality is not known. We studied...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics