Observational studyCritical care (London, England)2013
Prognostic consequences of borderline dysnatremia: pay attention to minimal serum sodium change.
Observational study in Critical care (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03093766 (Balance Study on ICU-acquired Hypernatremia and Sodium Handling), which is not on this map. Cited by 55 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Balance Study on ICU-acquired Hypernatremia and Sodium Handling
Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical practice guideline on diagnosis and treatment of hyponatraemia.Intensive care medicine · 2014Guideline
- Distinct osmoregulatory responses to sodium loading in patients with altered glycosaminoglycan structure: a randomized cross-over trial.Journal of translational medicine · 2021Trial
- Construction and validation of a risk prediction model for hyponatremia caused by cervical spinal cord injury.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Clinical outcomes associated with dynamic changes in serum sodium amongst adult patients with spontaneous subarachnoid hemorrhage and other critical illnesses: an exploratory scoping review.Critical care science · 2026Article
- Predicting mortality in critically ill patients: a machine learning approach to electrolyte imbalances and clinical risk factors.Journal of translational medicine · 2025Article
- Association between sodium-chloride difference at ICU admission and 30-day mortality: a retrospective cohort study of critically ill adults.BMC anesthesiology · 2025Article
- Sodium and chloride disturbances in critically ill adult patients: A protocol for a sub-study of the FLUID-ICU cohort study.Acta anaesthesiologica Scandinavica · 2025Article
- Early systemic insults following severe sepsis-associated encephalopathy of critically ill patients: association with mortality and awakening-an analysis of the OUTCOMEREA database.Journal of intensive care · 2025Article
- Severe intensive care unit-acquired hypernatraemia: Prevalence, risk factors, trajectory, management, and outcome.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Article
- Association between serum sodium trajectory and mortality in patients with acute kidney injury: a retrospective cohort study.BMC nephrology · 2024Article
- GLUCOSE AND SODIUM LEVELS AS DISEASE OUTCOME PREDICTORS IN CRITICALLY ILL PATIENTS.Acta clinica Croatica · 2023Article
- Prevention and Correction of Dysnatremia After Aneurysmal Subarachnoid Hemorrhage.Neurocritical care · 2023Review
- Post-operative dysnatremia is associated with adverse early outcomes after surgery for congenital heart disease.Pediatric research · 2023Article
- Nomogram Prediction Model of Hypernatremia on Mortality in Critically Ill Patients.Infection and drug resistance · 2023Article
- Hyponatremia in Patients Admitted to Intensive Care Unit of a Tertiary Center: A Descriptive Cross-sectional Study.JNMA; journal of the Nepal Medical Association · 2022Article
- Association of early dysnatremia with mortality in the neonatal intensive care unit: results from the AWAKEN study.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Nomogram Prediction Model of Serum Chloride and Sodium Ions on the Risk of Acute Kidney Injury in Critically Ill Patients.Infection and drug resistance · 2022Article
- Association Between Serum Sodium and Long-Term Mortality in Critically Ill Patients with Comorbid Chronic Obstructive Pulmonary Disease: Analysis from the MIMIC-IV Database.International journal of chronic obstructive pulmonary disease · 2022Article
- Perturbed body fluid distribution and osmoregulation in response to high salt intake in patients with hereditary multiple exostoses.Molecular genetics and metabolism reports · 2021Article
- A Prospective Cohort Study on Serum Sodium and Clinical Outcome in Pediatric Nontraumatic Coma.Indian journal of pediatrics · 2021Article
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTo assess the prevalence of dysnatremia, including borderline changes in serum sodium concentration, and to estimate the impact of these dysnatremia on mortality after adjustment for confounders.
methodsObservational study on a prospective database fed by 13 intensive care units (ICUs). Unselected patients with ICU stay longer than 48 h were enrolled over a 14-year period were included in this study. Mild to severe hyponatremia were defined as serum sodium concentration < 135, < 130, and < 125 mmol/L respectively. Mild to severe hypernatremia were defined as serum sodium concentration > 145, > 150, and > 155 mmol/L respectively. Borderline hyponatremia and hypernatremia were defined as serum sodium concentration between 135 and 137 mmol/L or 143 and 145 respectively.
resultsA total of 11,125 patients were included in this study. Among these patients, 3,047 (27.4%) had mild to severe hyponatremia at ICU admission, 2,258 (20.3%) had borderline hyponatremia at ICU admission, 1,078 (9.7%) had borderline hypernatremia and 877 (7.9%) had mild to severe hypernatremia. After adjustment for confounder, both moderate and severe hyponatremia (subdistribution hazard ratio (sHR) 1.82, 95% CI 1.002 to 1.395 and 1.27, 95% CI 1.01 to 1.60 respectively) were associated with day-30 mortality. Similarly, mild, moderate and severe hypernatremia (sHR 1.34, 95% CI 1.14 to 1.57; 1.51, 95% CI 1.15 to 1.99; and 2.64, 95% CI 2.00 to 3.81 respectively) were independently associated with day-30 mortality.
conclusionsOne-third of critically ill patients had a mild to moderate dysnatremia at ICU admission. Dysnatremia, including mild changes in serum sodium concentration, is an independent risk factor for hospital mortality and should not be neglected.
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