Prevalence and Prognostic Impact of Hypernatremia in Sepsis and Septic Shock Patients in The Intensive Care Unit: A Single Centre Experience
, , , , , , e | 31 gen 2020
INFORMAZIONI SU QUESTO ARTICOLO
Article Category: Research Article
Pubblicato online: 31 gen 2020
Pagine: 52 - 58
Ricevuto: 19 ott 2019
Accettato: 12 gen 2020
DOI: https://doi.org/10.2478/jccm-2020-0001
Parole chiave
© 2020 Mohamed Shirazy, Islam Omar, Duaa Abduljabbar, Kamel Bousselmi, Maryam Alkhaja, Anis Chaari, Vipin Kauts, Karim Hakim, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Relation between the Length of ICU stay and Sodium levels on Days 1, Days 3, and Days 7 (n=168)
| length of ICU stays | |||
|---|---|---|---|
| Median (Min. – Max.) | Mean ± SD. | p | |
| Low (<135) | 12 (1 – 210) | 20 ± 32.5 | |
| Normal (135 – 145) | 8 (1 – 112) | 16.8 ± 20.6 | 0.039* |
| High (>145) | 29.5 (5 – 88) | 34.4 ± 27.8 | |
| Low (<135) | 12 (3 – 120) | 17.8 ± 20.6 | |
| Normal (135 – 145) | 12 (1 – 210) | 23.2 ± 30.6 | 0.815 |
| High (>145) | 11.5 (3 – 80) | 20.6 ± 20.5 | |
| Low (<135) | 16 (8 – 88) | 21.4 ± 18.8 | |
| Normal (135 – 145) | 17.5 (1 – 210) | 27.1 ± 33.2 | 0.373 |
| High (>145) | 21 (3 – 80) | 32 ± 24.6 | |
Univariate and multivariate analysis for independent predictors of mortality
| p | Univariate OR (95%C.I) | p | #Multivariate OR (95%C.I) | |
|---|---|---|---|---|
| Age (years) | 0.004* | 1.040(1.013 – 1.068) | 0.114 | 1.034(0.992 – 1.078) |
| Gender | 0.938 | 1.026(0.541 – 1.944) | ||
| Unknown | 0.637 | 1.445(0.312 – 6.689) | ||
| Abdomen | 0.822 | 1.121(0.416 – 3.022) | ||
| Lungs | 0.331 | 1.373(0.725 – 2.600) | ||
| Urinary Tract | 0.865 | 1.064(0.520 – 2.175) | ||
| Central nervous system | 0.649 | 1.912(0.117 – 31.142) | ||
| Soft Tissue/Ulcer | 0.895 | 0.940(0.376 – 2.348) | ||
| Orthopaedic | 1.000 | - | ||
| Bloodstream infection | 0.271 | 3.893(0.345 – 43.866) | ||
| Diabetes mellitus | 0.085 | 1.901(0.916 – 3.947) | ||
| Chronic kidney disease | 0.048* | 1.972(1.006 – 3.865) | 0.562 | 1.32(0.521 – 3.326) |
| High blood pressure | 0.066 | 2.238(0.948 – 5.280) | ||
| Ischemic heart disease | 0.006* | 2.500(1.296 – 4.822) | 0.204 | 1.77(0.732 – 4.303) |
| Immunosuppressed | 0.001* | 3.176(1.558 – 6.478) | 0.026* | 2.99(1.141 – 7.848) |
| Serum Na (day1) | 0.489 | 0.983(0.937 – 1.031) | ||
| Serum Na (day3) | 0.630 | 1.015(0.956 – 1.077) | ||
| Serum Na (day7) | 0.020* | 1.082(1.013 – 1.157) | 0.039* | 1.08(1.004 – 1.154) |
Relation between Outcome and Sodium levels on Days 1, Days 3, and Days 7 (n= 168)
| Outcome | ||||
|---|---|---|---|---|
| Total (n= 168) | Survival (n= 110) | Death (n= 58) | p | |
| Low (<135) | 67 (39.9%) | 42 (38.2%) | 25 (43.1%) | |
| Normal (135 – 145) | 91 (54.2%) | 64 (58.2%) | 27 (46.6%) | |
| High (>145) | 10 (6%) | 4 (3.6%) | 6 (10.3%) | |
| Median (Min. – Max.) | 136 (109–152) | 136 (114–151) | 135 (109–152) | 0.388 |
| Mean ± SD. | 135.6± 6.6 | 135.6± 5.9 | 134.8± 7.9 | |
| Low (<135) | 39(26.4%) | 25 (25%) | 14 (29.2%) | |
| Normal (135 – 145) | 95(64.2%) | 69 (69%) | 26 (54.2%) | |
| High (>145) | 14(9.5%) | 6 (6%) | 8 (16.7%) | |
| Median (Min. – Max.) | 138 (113–155) | 138 (118–155) | 137 (113–152) | 0.709 |
| Mean ± SD. | 137.9 ± 5.8 | 137.8 ± 5 | 137.8 ± 7.3 | |
| Low (<135) | 22 (19.5%) | 16 (22.2%) | 6 (14.6%) | |
| Normal (135 – 145) | 70 (61.9%) | 47 (65.3%) | 23 (56.1%) | |
| High (>145) | 21 (18.6%) | 9 (12.5%) | 12 (29.3%) | |
| Median (Min. – Max.) | 139 (120–154) | 138 (120–154) | 141 (130–152) | 0.030* |
| Mean ± SD. | 139.3 ± 6.2 | 138.3 ± 6 | 141.2 ± 6.3 | |
Relationships between Outcome and Demographic data, Comorbidities, and Sources of Sepsis (n= 168)
| Outcome | ||||
|---|---|---|---|---|
| Total (n= 168) | Survival (n= 110) | Death (n= 58) | p | |
| Male | 92 (54.8%) | 60 (54.5%) | 32 (55.2%) | 0.938 |
| Female | 76 (45.2%) | 50 (45.5%) | 26 (44.8%) | |
| Median (Min. – Max.) | 69 (26 – 104) | 67 (26 – 97) | 74 (34 – 104) | 0.001* |
| Mean ± SD. | 68.5 ± 13.3 | 72.7 ± 10.9 | 66.3 ± 14 | |
| Diabetes mellitus | 116 (69%) | 71 (64.5%) | 45 (77.6%) | 0.082 |
| Chronic kidney disease | 53 (31.5%) | 29 (26.4%) | 24 (41.4%) | 0.046* |
| High blood pressure | 131 (78%) | 81 (73.6%) | 50(86.2%) | 0.062 |
| Ischemic heart disease | 63 (37.5%) | 33 (30%) | 30 (51.7%) | 0.046* |
| Immunosuppressed | 44 (73.8%) | 20 (20) | 24 (41.4%) | 0.002* |
| Unknown | 7 (4.2%) | 3 (5.2%) | 4(3.6%) | 0.694 |
| Abdomen | 19 (11.3%) | 12 (10.9%) | 7 (12.1%) | 0.821 |
| Lungs | 84 (50%) | 52 (47.3%) | 32 (55.2%) | 0.330 |
| Urinary Tract | 45 (26.8%) | 29 (26.4%) | 16 (27.6%) | 0.865 |
| Central nervous system | 2 (1.2%) | 1 (0.9%) | 1 (1.7%) | 1.000 |
| Soft Tissue/Ulcer | 24 (14.3%) | 16 (14.5%) | 8 (13.8%) | 0.895 |
| Orthopedic | 1 (0.6%) | 1 (0.9%) | 0 (0%) | 1.000 |
| Blood stream infection | 3 (1.8%) | 2 (3.4%) | 1 (0.9%) | 0.274 |
Relationships between the length of ICU stay and Demographic data, Comorbidities, and Source of Sepsis (n=168)
| length of ICU stays | |||
|---|---|---|---|
| Median (Min. – Max.) | Mean ± SD. | p | |
| Male | 10 (1 – 120) | 17 ± 20.5 | 0.892 |
| Female | 9.5 (1 – 210) | 21.8 ± 32.3 | |
| Diabetes mellitus | 12 (1 – 210) | 21.8 ± 29.5 | 0.011* |
| Chronic kidney disease | 14 (1 – 124) | 25.2 ± 26.1 | 0.003* |
| High blood pressure | 10 (1 – 210) | 20.8 ± 28.9 | 0.229 |
| Ischemic heart disease | 10 (1 – 210) | 20.1 ± 30.5 | 0.999 |
| Immunosuppressed | 10.5 (2 – 120) | 21.5 ± 25.7 | 0.406 |
| Unknown | 21 (5 – 120) | 42.7 ± 44.2 | 0.046* |
| Abdomen | 19 (3 – 57) | 22.9 ± 19.3 | 0.101 |
| Lungs | 11.5 (1 – 210) | 24 ± 34.1 | 0.292 |
| Urinary Tract | 9 (1 – 120) | 16 ± 22.5 | 0.277 |
| Central nervous system | 20 (15 – 25) | 20 ± 7.1 | 0.371 |
| Soft Tissue/Ulcer | 12.5 (2 – 68) | 16.6 ± 15.8 | 0.652 |
| Orthopedic | 5# | - | |
| Bloodstream infection | 8 (2 – 21) | 10.3 ± 9.7 | 0.606 |