P75 | Hypernatremia is associated with increased risk of mortality in patients admitted to Internal Medicine units for community acquired pneumonia
I. Giarretta1, F. Tangianu1, O. De Falco2, M. Cavalleri3, F. Pieralli4, F. Dentali1 | 1Dipartimento di Area Medica Ospedale di Circolo e Fondazione Macchi, Varese, 2Dipartimento di Medicina, Chirurgia e Farmacia, Università di Sassari, 3Dipartimento Medico ad Elevata Integrazione Territoriale, Sestri Levante (GE), 4Dipartimento di Medicina Interna e Cure Intermedie, Ospedale Careggi, Firenze, Italy
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Introduction: Community-acquired pneumonia (CAP) is a frequent and clinically challenging infection and a leading cause of hospitalization to Internal Medicine units (IMUs). Patients admitted to IMUs may develop sodium disorders, and hyponatremia, but not hypernatremia, is considered a risk factor for adverse outcomes in CAP. On the other hand, hypernatremia has been associated with adverse outcomes in several diseases. In this study we evaluated the effect of hypernatremia on clinical outcomes in patients with CAP.
Methods: We enrolled 1241 patients hospitalized for CAP in 26 Italian IMUs from October 2016 to February 2018. The primary outcome was a composite of 30-day mortality, need for intensive care unit admission, or rehospitalization at 30 days. Univariate and multivariate analyzes were performed to evaluate the association between hypernatremia and outcomes.
Results: The median age of the included patients was 79 years (IQR 71-86) with a slight prevalence of men (51.2%). The prevalence of hypernatremia was 5.7% (95%, CI: 4.41-6.99) and was significantly associated with the primary outcome (OR of 3.06; 95% CI 1.85-5.09). The strongest association was found with mortality (OR 5.05, 95% CI 2.93-8.70), while sodium disorders were not associated with the need for ICU admission or re-hospitalization.
Conclusions: Our study suggests a strong association between hypernatremia and adverse outcomes in patients with CAP, further studies are needed to evaluate the impact of including increased sodium levels in common risk scores for mortality in this patient setting.
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