ArticleBurns & trauma2017
Sodium variability is associated with increased mortality in severe burn injury.
Article in Burns & trauma, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 30 citations in OpenAlex.
- Novel application of an automated-machine learning development tool for predicting burn sepsis: proof of concept.Scientific reports · 2020Trial
- Dynamic variability of serum sodium, potassium, and calcium and mortality after acute myocardial infarction: insights from traditional and machine learning approaches.BMC cardiovascular disorders · 2026Article
- The Impact of Concomitant Traumatic Brain Injuries on the Surgical Treatment of Burns: A Long-Term, Monocentric Retrospective Study.Journal of burn care & research : official publication of the American Burn Association · 2026Article
- Development and validation of a prediction model for hypernatremia in patients with severe burns.Frontiers in medicine · 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
- Dynamic sodium dysregulation predicts mortality in intracerebral hemorrhage: A retrospective cohort study of temporal variability and absolute thresholds.Neurosurgical review · 2025Article
- Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings.European burn journal · 2024Review
- Hyponatremia after COVID-19 is frequent in the first year and increases re-admissions.Scientific reports · 2024Observational
- Effect of high sodium ion level on the interaction of AmB with a cholesterol-rich phospholipid monolayer.Frontiers in molecular biosciences · 2024Article
- The Extent of Burn Injury Significantly Affects Serum Micro- and Macroelement Concentrations in Patients on the First Day of Hospitalisation.Nutrients · 2022Article
- Sodium Balance Analysis In The Burn Resuscitation Period.Annals of burns and fire disasters · 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
- Hypernatremia Risk Factors And Prognostic Impact In Burn Patients: A Case Control Study.Annals of burns and fire disasters · 2021Article
- Variability in Serum Sodium Concentration and Prognostic Significance in Severe Traumatic Brain Injury: A Multicenter Observational Study.Neurocritical care · 2021Observational
- Increased mortality risk associated with serum sodium variations and borderline hypo- and hypernatremia in hospitalized adults.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020Article
- Mortality following combined burn and traumatic brain injuries: An analysis of the national trauma data bank of the American College of Surgeons.Burns : journal of the International Society for Burn Injuries · 2020Article
- Article
- The Dynamics of the Skin's Immune System.International journal of molecular sciences · 2019Review
- Where there is sodium there may be sepsis.Journal of community hospital internal medicine perspectives · 2019Article
- Risk factors and outcome of Hypernatremia amongst severe adult burn patients.Annals of burns and fire disasters · 2018Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDysnatremias are associated with increased mortality in critically ill patients. Hypernatremia in burn patients is also associated with poor survival. Based on these findings, we hypothesized that high plasma sodium variability is a marker for increased mortality in severely burn-injured patients.
methodsWe performed a retrospective review of adult burn patients with a burn injury of 15% total body surface area (TBSA) or greater from 2010 to 2014. All patients included in the study had at least three serum sodium levels checked during admission. We used multivariate logistic regression analysis to determine if hypernatremia, hyponatremia, or sodium variability independently increased the odds ratio (OR) for death.
resultsTwo hundred twelve patients met entry criteria. Mean age and %TBSA for the study was 45 ± 18 years and 32 ± 19%. Twenty-nine patients died for a mortality rate of 14%. Serum sodium was measured 10,310 times overall. The median number of serum sodium measurements per patient was 22. Non-survivors were older (59 ± 19 vs. 42 ± 16 years) and suffered from a more severe burn injury (50 ± 25% vs. 29 ± 16%TBSA). While mean sodium was significantly higher for non-survivors (138 ± 3 milliequivalents/liter (meq/l)) than for survivors (135 ± 2 meq/l), mean sodium levels remained within the laboratory reference range (135 to 145 meq/l) for both groups. Non-survivors had a significantly higher median number of hypernatremic (> 145 meq/l) measurements (2 vs. 0). Coefficient of variation (CV) was significantly higher in non-survivors (2.85 ± 1.1) than survivors (2.0 ± 0.7). Adjusting for TBSA, age, ventilator days, and intensive care unit (ICU) stay, a higher CV of sodium measurements was associated with mortality (OR 5.8 (95% confidence interval (CI) 1.5 to 22)). Additionally, large variation in sodium ranges in the first 10 days of admission may be associated with increased mortality (OR 1.35 (95% CI 1.06 to1.7)).
conclusionsIncreased variability in plasma sodium may be associated with death in severely burned patients.
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