Mortality and Neurologic Outcomes in Rapid vs. Slow Hyponatremia Correction

Mortality and Neurologic Complications Associated With Rapid Versus Slow Correction of Hyponatremia

This study examines the impact of different rates of sodium correction on the outcomes of patients with severe hyponatremia (serum sodium ≤ 120 mEq/L). Hyponatremia is a condition where blood sodium levels are dangerously low, and its treatment must be carefully managed to avoid complications. Standard guidelines recommend correcting sodium levels slowly to prevent a rare but serious neurological condition called osmotic demyelination syndrome (ODS). However, recent evidence suggests that a faster rate of sodium correction may reduce hospital stay length and mortality without increasing the risk of ODS.

This retrospective study, conducted from 2010 to 2023 at a hospital in Buenos Aires, Argentina. It compares the outcomes of patients who had their sodium levels corrected rapidly (≥ 8 mEq/L in 24 hours) to those who had slower corrections. The primary outcomes measured are mortality and the development of ODS.

Inclusion Criteria:

• Patients aged 18 years or older.
• First hospitalization at Hospital Italiano de Buenos Aires with a serum sodium (natremia) level ≤ 120 mEq/L at admission.

Exclusion Criteria:

• Absence of serum sodium values after the first 24 hours of hospitalization.
• Hospitalizations shorter than 24 hours.
• Patients with previous hospitalizations prior to the study period where admission serum sodium levels were ≤ 120 mEq/L.