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Kremeike K, Wetter RML, Burst V, Voltz R, Kuhr K, Simon ST. Prevalence of hyponatremia in inpatients with incurable and life-limiting diseases and its association with physical symptoms-a retrospective descriptive study. Support Care Cancer 2017; 26:213-222. [PMID: 28821989 DOI: 10.1007/s00520-017-3837-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/24/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE Hyponatremia is a common electrolyte abnormality seen in hospitalized patients. It may cause a variety of symptoms and is associated with longer hospitalizations and higher mortality. However, to date, only little is known about the extent of hyponatremia in patients with incurable diseases and whether it is associated with physical symptoms in this patient group. This study aims to describe the prevalence of hyponatremia, associated symptoms, and symptom intensity in inpatients with hyponatremia receiving specialist palliative care (SPC). METHODS This is a retrospective study. Demographic and clinical data as well as symptoms, scored symptom intensity, and laboratory values were collected. All inpatients of a large German University Hospital receiving SPC in 2013 with documented sodium values were included. RESULTS In 2013, 789 inpatients received SPC of which 710 had documented sodium values. The prevalence of hyponatremia was 38.7% (275/710). A mild degree showed 220 (31,0%), 44 (6.2%) had a moderate, and 11 (1.6%) a severe form. Hyponatremia patients experienced significantly more symptoms than normonatremic patients (mean = 7.71 vs 6.63; p < 0.001). Breathlessness, depressiveness, nausea, vomiting, poor appetite, constipation, and weakness were significantly more frequent in patients with hyponatremia. Furthermore, hyponatremia severity was associated with higher symptom intensity (mean = 13.29 vs 11.28; p < 0.001). CONCLUSIONS More than one third of all SPC patients showed a hyponatremia, and the hyponatremia grade was associated with symptom burden and symptom intensity. A prospective analysis is needed to further examine this association and the possible influence of hyponatremia correction on symptom burden reduction.
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Affiliation(s)
- Kerstin Kremeike
- Department of Palliative Medicine, University Hospital Cologne, Kerpener Str. 62, 50397, Cologne, Germany.,Centre for Integrated Oncology Köln Bonn (CIO), University Hospital Cologne, Cologne, Germany
| | - Ricarda M L Wetter
- Department of Palliative Medicine, University Hospital Cologne, Kerpener Str. 62, 50397, Cologne, Germany.,Centre for Integrated Oncology Köln Bonn (CIO), University Hospital Cologne, Cologne, Germany
| | - Volker Burst
- Department 2 of Internal Medicine, Nephrology, University Hospital Cologne, Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, University Hospital Cologne, Kerpener Str. 62, 50397, Cologne, Germany.,Centre for Integrated Oncology Köln Bonn (CIO), University Hospital Cologne, Cologne, Germany.,Clinical Trials Center Cologne, (ZKS), Köln, Germany.,Center for Health Services Research (ZVFK), Medical Faculty, University of Cologne, Cologne, Germany
| | - Kathrin Kuhr
- Institute of Medical Statistics, Informatics and Epidemiology (IMSIE), University Hospital Cologne, Cologne, Germany
| | - Steffen T Simon
- Department of Palliative Medicine, University Hospital Cologne, Kerpener Str. 62, 50397, Cologne, Germany. .,Centre for Integrated Oncology Köln Bonn (CIO), University Hospital Cologne, Cologne, Germany. .,Clinical Trials Center Cologne, (ZKS), Köln, Germany.
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