­Sodium Deficiency Worsens Outcomes in COPD Patients

Patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD)) who have hyponatremia have worse outcomes than those who do not have hyponatremia, according to a new study from Spain.

While hyponatremia is the most common electrolyte disorder in hospitalized patients, its frequency in patients hospitalized for COPD exacerbations and its impact on morbidity and mortality are unknown.
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To further understand the condition in this patient population, the researchers examined data from 424 patients hospitalized for a COPD exacerbation at a teaching hospital in Spain from January 2014 to July 2015.

The mean plasma sodium level among patients was 137.8±3.7 mEq/L, and all patients had a similar age, comorbidities, lung function impairment, presence of previous exacerbations, hospitalizations, and overall severity index score (APACHE II).

About 16% of patients included in the study had hyponatremia. Patients with hyponatremia had longer hospital stays, more mechanical ventilation requirements, and higher death rates (both during admission and within the months following discharge) than those without hyponatremia. A sodium threshold lower than 129.7 mEq/L was the best predictor of death.

“[H]yponatremia (especially if severe) is a predictive marker for a bad clinical course in COPD exacerbations and therefore, patients with this electrolyte abnormality should be carefully monitored,” the researchers concluded.

—Amanda Balbi

Reference:

Chalela R, González-García JG, Chillarón JJ, et al. Impact of hyponatremia on mortality and morbidity in patients with COPD exacerbations [published online June 29, 2016]. Respir Med. http://dx.doi.orsg/10.1016/j.rmed.2016.05.003.