Factors associated with sodium correction >8 mEq/L at 24 hours in patients admitted to Geisinger system hospitals with an initial serum sodium <120 mEq/L
Variables | OR (95% CI) | |||
---|---|---|---|---|
Unadjusted | Model 1 | Model 2 | Model 3 | |
Academic center | 0.65 (0.53 to 0.81)a | 0.70 (0.54 to 0.90)a | 0.70 (0.52 to 0.94)b | 0.70 (0.54 to 0.91)a |
Women | 1.34 (1.08 to 1.65)a | 1.49 (1.14 to 1.96)a | 1.73 (1.26 to 2.37)a | 1.50 (1.14 to 1.96)a |
Age, per 1 yr | 0.98 (0.97 to 0.99)a | 0.98 (0.97 to 0.99)a | 0.98 (0.97 to 0.99)a | 0.98 (0.97 to 0.99)a |
White | 1.03 (0.49 to 2.15) | 1.03 (0.37 to 2.92) | 0.74 (0.23 to 2.35) | 1.01 (0.36 to 2.88) |
Schizophrenia | 2.73 (1.34 to 5.57)a | 2.24 (1.03 to 4.89)b | 2.48 (1.02 to 6.02)b | 2.24 (1.03 to 4.88)b |
Congestive heart failure | 0.60 (0.45 to 0.81)a | 0.94 (0.66 to 1.33) | 1.08 (0.72 to 1.63) | 0.94 (0.67 to 1.34) |
Charlson comorbidity index | 0.86 (0.82 to 0.89)a | 0.94 (0.89 to 0.99)b | 0.93 (0.87 to 0.99)b | 0.94 (0.88 to 0.99)b |
Outpatient Na+ <135 | 0.52 (0.41 to 0.67)a | 0.62 (0.48 to 0.81)a | 0.62 (0.46 to 0.84)a | 0.62 (0.48 to 0.81)a |
Inpatient baseline Na+ at hospitalization | 0.88 (0.86 to 0.91)a | 0.90 (0.87 to 0.93)a | 0.90 (0.87 to 0.93)a | 0.90 (0.87 to 0.93)a |
Urine Na+ <30 mEq/L | 1.46 (1.15 to 1.85)a | 1.58 (1.17 to 2.13)a | ||
K+≥5 mEq/L | 0.87 (0.66 to 1.16) | 1.22 (0.88 to 1.71) | 1.14 (0.76 to 1.70) | 1.23 (0.87 to 1.74) |
K+<3.5 mEq/L | 1.81 (1.41 to 2.33)a | 1.32 (0.97 to 1.79) | 1.39 (0.97 to 1.97) | 1.24 (0.88 to 1.73) |
Loop diuretics (outpatient) | 0.42 (0.31 to 0.56)a | 0.71 (0.49 to 1.02) | 0.66 (0.43 to 1.01) | 0.71 (0.49 to 1.02) |
Aldosterone antagonists (outpatient) | 0.33 (0.21 to 0.52)a | 0.48 (0.28 to 0.82)a | 0.45 (0.23 to 0.84)b | 0.48 (0.28 to 0.83)a |
Hypertonic saline (inpatient) | 2.03 (1.49 to 2.76)a | 1.09 (0.73 to 1.64) | ||
Electrolyte repletion (inpatient) | 1.71 (1.37 to 2.13a | 1.14 (0.84 to 1.55) | ||
Vaptans (inpatient) | 0.93 (0.36 to 2.41) | 1.21 (0.40 to 3.63) | ||
ICU stay in the first 24 h after admission | 1.01 (0.78 to 1.30) | 1.07 (0.79 to 1.44) |
Model 1 included all significant unadjusted risk factors of rapid correction except for urine sodium or inpatient treatment factors. Model 2 included model 1 covariates and urine sodium (<30 or ≥30 mEq/L). Model 3 included model 1 covariates and inpatient treatment factors. OR, odds ratio; 95% CI, 95% confidence interval; Na+, sodium; K+, potassium; ICU, intensive care unit.
↵a Significant at P=0.01.
↵b Significant at P=0.05.