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Prevalence and Prognostic Impact of Hypernatremia in Sepsis and Septic Shock Patients in The Intensive Care Unit: A Single Centre Experience Cover

Prevalence and Prognostic Impact of Hypernatremia in Sepsis and Septic Shock Patients in The Intensive Care Unit: A Single Centre Experience

Open Access
|Jan 2020

Figures & Tables

Relation between the Length of ICU stay and Sodium levels on Days 1, Days 3, and Days 7 (n=168)

length of ICU stays
Median (Min. – Max.)Mean ± SD.p
Serum Na (day1)
Low (<135)12 (1 – 210)20 ± 32.5
Normal (135 – 145)8 (1 – 112)16.8 ± 20.60.039*
High (>145)29.5 (5 – 88)34.4 ± 27.8
Serum Na (day3)
Low (<135)12 (3 – 120)17.8 ± 20.6
Normal (135 – 145)12 (1 – 210)23.2 ± 30.60.815
High (>145)11.5 (3 – 80)20.6 ± 20.5
Serum Na (day7)
Low (<135)16 (8 – 88)21.4 ± 18.8
Normal (135 – 145)17.5 (1 – 210)27.1 ± 33.20.373
High (>145)21 (3 – 80)32 ± 24.6

Univariate and multivariate analysis for independent predictors of mortality

pUnivariate OR (95%C.I)p#Multivariate OR (95%C.I)
Age (years)0.004*1.040(1.013 – 1.068)0.1141.034(0.992 – 1.078)
Gender0.9381.026(0.541 – 1.944)
Source of sepsis
Unknown0.6371.445(0.312 – 6.689)
Abdomen0.8221.121(0.416 – 3.022)
Lungs0.3311.373(0.725 – 2.600)
Urinary Tract0.8651.064(0.520 – 2.175)
Central nervous system0.6491.912(0.117 – 31.142)
Soft Tissue/Ulcer0.8950.940(0.376 – 2.348)
Orthopaedic1.000-
Bloodstream infection0.2713.893(0.345 – 43.866)
Comorbidities
Diabetes mellitus0.0851.901(0.916 – 3.947)
Chronic kidney disease0.048*1.972(1.006 – 3.865)0.5621.32(0.521 – 3.326)
High blood pressure0.0662.238(0.948 – 5.280)
Ischemic heart disease0.006*2.500(1.296 – 4.822)0.2041.77(0.732 – 4.303)
Immunosuppressed0.001*3.176(1.558 – 6.478)0.026*2.99(1.141 – 7.848)
Serum Na (day1)0.4890.983(0.937 – 1.031)
Serum Na (day3)0.6301.015(0.956 – 1.077)
Serum Na (day7)0.020*1.082(1.013 – 1.157)0.039*1.08(1.004 – 1.154)

Relation between Outcome and Sodium levels on Days 1, Days 3, and Days 7 (n= 168)

Outcome
Total (n= 168)Survival (n= 110)Death (n= 58)p
Serum Na (day1)
Low (<135)67 (39.9%)42 (38.2%)25 (43.1%)
Normal (135 – 145)91 (54.2%)64 (58.2%)27 (46.6%)
High (>145)10 (6%)4 (3.6%)6 (10.3%)
Median (Min. – Max.)136 (109–152)136 (114–151)135 (109–152)0.388
Mean ± SD.135.6± 6.6135.6± 5.9134.8± 7.9
Serum Na (day3)
Low (<135)39(26.4%)25 (25%)14 (29.2%)
Normal (135 – 145)95(64.2%)69 (69%)26 (54.2%)
High (>145)14(9.5%)6 (6%)8 (16.7%)
Median (Min. – Max.)138 (113–155)138 (118–155)137 (113–152)0.709
Mean ± SD.137.9 ± 5.8137.8 ± 5137.8 ± 7.3
Serum Na (day7)
Low (<135)22 (19.5%)16 (22.2%)6 (14.6%)
Normal (135 – 145)70 (61.9%)47 (65.3%)23 (56.1%)
High (>145)21 (18.6%)9 (12.5%)12 (29.3%)
Median (Min. – Max.)139 (120–154)138 (120–154)141 (130–152)0.030*
Mean ± SD.139.3 ± 6.2138.3 ± 6141.2 ± 6.3

Relationships between Outcome and Demographic data, Comorbidities, and Sources of Sepsis (n= 168)

Outcome
Total (n= 168)Survival (n= 110)Death (n= 58)p
Gender
Male92 (54.8%)60 (54.5%)32 (55.2%)0.938
Female76 (45.2%)50 (45.5%)26 (44.8%)
Age (years)
Median (Min. – Max.)69 (26 – 104)67 (26 – 97)74 (34 – 104)0.001*
Mean ± SD.68.5 ± 13.372.7 ± 10.966.3 ± 14
Comorbidities
Diabetes mellitus116 (69%)71 (64.5%)45 (77.6%)0.082
Chronic kidney disease53 (31.5%)29 (26.4%)24 (41.4%)0.046*
High blood pressure131 (78%)81 (73.6%)50(86.2%)0.062
Ischemic heart disease63 (37.5%)33 (30%)30 (51.7%)0.046*
Immunosuppressed44 (73.8%)20 (20)24 (41.4%)0.002*
Source of sepsis
Unknown7 (4.2%)3 (5.2%)4(3.6%)0.694
Abdomen19 (11.3%)12 (10.9%)7 (12.1%)0.821
Lungs84 (50%)52 (47.3%)32 (55.2%)0.330
Urinary Tract45 (26.8%)29 (26.4%)16 (27.6%)0.865
Central nervous system2 (1.2%)1 (0.9%)1 (1.7%)1.000
Soft Tissue/Ulcer24 (14.3%)16 (14.5%)8 (13.8%)0.895
Orthopedic1 (0.6%)1 (0.9%)0 (0%)1.000
Blood stream infection3 (1.8%)2 (3.4%)1 (0.9%)0.274

Relationships between the length of ICU stay and Demographic data, Comorbidities, and Source of Sepsis (n=168)

length of ICU stays
Median (Min. – Max.)Mean ± SD.p
Gender
Male10 (1 – 120)17 ± 20.50.892
Female9.5 (1 – 210)21.8 ± 32.3
Comorbidities
Diabetes mellitus12 (1 – 210)21.8 ± 29.50.011*
Chronic kidney disease14 (1 – 124)25.2 ± 26.10.003*
High blood pressure10 (1 – 210)20.8 ± 28.90.229
Ischemic heart disease10 (1 – 210)20.1 ± 30.50.999
Immunosuppressed10.5 (2 – 120)21.5 ± 25.70.406
Source of sepsis
Unknown21 (5 – 120)42.7 ± 44.20.046*
Abdomen19 (3 – 57)22.9 ± 19.30.101
Lungs11.5 (1 – 210)24 ± 34.10.292
Urinary Tract9 (1 – 120)16 ± 22.50.277
Central nervous system20 (15 – 25)20 ± 7.10.371
Soft Tissue/Ulcer12.5 (2 – 68)16.6 ± 15.80.652
Orthopedic5#-
Bloodstream infection8 (2 – 21)10.3 ± 9.70.606
DOI: https://doi.org/10.2478/jccm-2020-0001 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 52 - 58
Submitted on: Oct 19, 2019
Accepted on: Jan 12, 2020
Published on: Jan 31, 2020
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2020 Mohamed Shirazy, Islam Omar, Duaa Abduljabbar, Kamel Bousselmi, Maryam Alkhaja, Anis Chaari, Vipin Kauts, Karim Hakim, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.