Heart failure & cardiomyopathiesCohort study
Hyponatraemia and Changes in Natraemia During Hospitalization for Acute Heart Failure and Associations with In-Hospital and Long-Term Outcomes – from the ESC-HFA EORP Heart Failure Long-Term Registry
- Registry-based cohort study
- ESC-HFA EORP Heart Failure Long-Term Registry
Authors' conclusion
Among patients with AHF, 20% had hyponatraemia at admission, which was associated with more advanced heart failure and normalized in half of patients during hospitalization. Admission hyponatraemia (possibly dilutional), especially if it did not resolve, was associated with worse in-hospital and post-discharge outcomes. Hyponatraemia developing during hospitalization (possibly depletional) was associated with lower risk.
Study context
- Population
- Patients hospitalised for acute HF with any EF
- Participants
- 8,298 patients
- Exposure
- Hyponatraemia at admission/discharge combinations vs no hyponatraemia
Main finding
As reported in the abstract
Prevalence of hyponatraemia at admission
20%
Observational data: associations, not effects.
Further findings
In-hospital mortality by hyponatraemia combination
Prevalence
| Outcome | adjusted HR (95% CI) | |
|---|---|---|
| 12-month mortality (hospital survivors) · 12 months — Yes/Yes vs No/No | 1.60 (1.35–1.89) | |
| 12-month mortality (hospital survivors) · 12 months — Yes/No vs No/No | 1.35 (1.14–1.59) | |
| 12-month mortality (hospital survivors) · 12 months — No/Yes vs No/No | 1.18 (0.96–1.45) | |
| Death or HF hospitalisation (hospital survivors) · 12 months — Yes/Yes vs No/No | 1.38 (1.21–1.58) | |
| Death or HF hospitalisation (hospital survivors) · 12 months — Yes/No vs No/No | 1.17 (1.02–1.33) | |
| Death or HF hospitalisation (hospital survivors) · 12 months — No/Yes vs No/No | 1.09 (0.93–1.27) | |
| 0.512Adjusted hazard ratio (log scale) |
- In-hospital mortality by hyponatraemia combination — Overall in-hospital death
- 3.3%
- 12-month mortality (hospital survivors) — Overall 12-month mortality
- 19%
Hospital course
- Correction of hyponatraemia associated with improvement in estimated glomerular filtration rate (eGFR)
- In-hospital development of hyponatraemia associated with greater diuretic use, worsening eGFR and more effective decongestion
Original publication
Summarised from the published abstract; every number is checked against it