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Investigating risk factors associated with hyponatremia in hospitalised patients using an electronic prescribing system with health records

Nwulu, Ugochi, Chuchu, N., Hodson, J., McDowell, S.E., Coleman, J.J. (2012) Investigating risk factors associated with hyponatremia in hospitalised patients using an electronic prescribing system with health records. In: British Pharmacological Society Winter Meeting, 19th December 2012, London. (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:48387)

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Abstract

Hyponatraemia, defined as a serum sodium concentration of <135mmol/l, is the most commonly encountered electrolyte disturbance in hospital patients. Various studies have shown that hyponatraemia occurs in up to 30% of hospitalised patients. Hyponatraemia has been associated with older age, low body weight, chronic diseases and diuretic therapy to name but a few.

Methodology

Statistical tests for categorical and non-parametric data were used to examine the null hypothesis that there was no difference in risk factors and outcomes between hyponatraemic and non-hyponatraemic patients. A multivariate logistic regression model of risk factors associated with hyponatraemia was fitted.

Data from 22,306 patients were analysed and 19% were classified as hyponatraemic during their in-patient spell. The risk of hyponatraemia was greater with increasing age - especially in those aged 60-69 (adjusted OR 2.2; 95% C.I. 1.6-2.9; p<0.001). The risk of hyponatraemia was also found to be greater for patients who were underweight (unadjusted OR 1.4; 1.1-1.7; p<0.001). Patients with Stage 5 renal failure were found to have a three-fold increased risk of hyponatraemia compared to those with less severe renal failure (adjusted OR 2.5; 1.9-3.2; p<0.001). Those patients with a higher Charlson Comorbidity Index (?13) were more likely to have hyponatraemia (adjusted OR 1.3; 1.1-1.6; p<0.05).

Conclusions

This study demonstrated that approximately 1 in 5 patients experienced hyponatraemia during their admission in this hospital and were more likely to have poorer outcomes than non-hyponatraemics. We concluded that this is a relatively convenient form of data extraction and the results can be used to better understand the risk factors associated with hyponatraemia. Some associations, such as diuretics, have a direct causal relationship and in some cases hyponatraemia may be a marker of increasing comorbidity. The next steps would be to use these results (incorporating them into algorithms) to alert health care professionals and guide them whilst they use electronic prescribing systems, thereby ensuring that patients receive the most appropriate care and management whilst in hospital.

Item Type: Conference or workshop item (Speech)
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 13 May 2015 08:30 UTC
Last Modified: 29 May 2019 14:32 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/48387 (The current URI for this page, for reference purposes)
Nwulu, Ugochi: https://orcid.org/0000-0001-6372-176X
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