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Table 2 Epidemiology of hyponatremia in the ICU and impact on outcome

From: Hyponatremia in the intensive care unit: How to avoid a Zugzwang situation?

First author, year of publication Study methodology Definition of hyponatremia Number/total population (%)c Patient characteristics associated with hyponatremia Outcomes significantly associated with hyponatremia
Univariate analysis Multivariate analysis Studied variable Outcomee
Vandergheinst, 2013 Prospective, 1 day multicentric 1265 ICUs <135 mmol/L 1713/13,796 (12.9 %) SAPS II
SOFA
ICU LOS (129 < PNa < 135)
Cirrhosis (PNa < 130)
Infection (125 < PNa < 135)
Medical (PNa < 125)
Hyponatremia, according to severity and type Increased hospital mortality (whole population)f
1. Severity of hyponatremiaa
2. Type of hyponatremia
 On admission
 ICU acquiredb
3. Whole population
Sakr, 2013 Retrospective
Monocentric
1 ICU
<135 mmol/L 1215/10,923d (11.2 %) SAPSII
ICU LOS
Diabetes
Cancer
Hematological cancer
AKI
Hyponatremia on admission Increased hospital mortality
 On admission
1483/10,923d (13.6 %)
 ICU acquiredb
Darmon, 2013 Retrospective 13 ICUs <135 mmol/L
Severity of hyponatremiaa on admission
3047/11,125 (9.7 %)    Hyponatremia according to severity Increased day-30 mortality (for moderate and severe hyponatremia)h
Study, year of publication Study methodology Definition of hyponatremia Number/total population (%)c Patient characteristics associated with hyponatremia Hyponatremia as a risk factor for ICU
Univariate analysis Multivariate analysis Studied variable Outcomee
Funk, 2010 Retrospective multicentric 77 ICUs = or <135 mmol/L on admission 26,782/151,486 (17.7 %) Hyponatremia Increased hospital mortality
Stelfox, 2008 Retrospective multicentric 3 ICUs <133 mmol/L
ICU acquiredb
917/8142 (11 %) Age
Setting
Hyponatremia Increased ICU mortality
 Neurosurgical
 Surgical
 Trauma patients
APACHE II
GCS score
Glucose level
K+ >5 mmol/L
T° > 37.3 °C and T° °C < 35 °C
Bennani, 2003 Retrospective monocentric 1 ICU <130 mmol/L
Severity of hyponatremiag on admission
300/2188 (13.7 %)    Hyponatremia according to severity Increased hospital mortality (PNa < 125 mmol/L)
deVita, 1990 Retrospective monocentric 1 ICU <135 mmol/L on admission 24/98 (24.5 %) _ _
  1. ICU intensive care unit
  2. aAs defined by mild hyponatremia: PNa comprised between 130 and 134 mmol/L, moderate hyponatremia: PNa comprised between 125 and 129 mmol/L, severe hyponatremia: PNa <125 mmol/L
  3. bAcquired during the ICU stay
  4. cThe variables are number of patients with hyponatremia, total number of patients admitted during the study period, percentage of patients with hyponatremia (%)
  5. dNumber of patients with hyponatremia, total number of patients admitted during the study period, percentage of patients with hyponatremia (%) upon ICU admission and acquired during the ICU stay
  6. eIn each case there is a positive correlation between the studied variable and the defined outcome
  7. fPatients with hyponatremia admitted in the ICU during the study day or prior to the study day
  8. gAs defined by mild hyponatremia: PNa comprised between 125 and 129 mmol/L, moderate hyponatremia: PNa comprised between 120 and 124 mmol/L, severe hyponatremia: PNa <120 mmol/L
  9. hAs defined by moderate hyponatremia: PNa comprised between 125 and 129 mmol/L, severe hyponatremia: PNa <125 mmol/L