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Rate of Sodium Correction and Osmotic Demyelination Syndrome in Severe Hyponatremia: A Meta-Analysis

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31 lip 2024

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Fig. 1.

Forest plot showing the association between rapid serum sodium correction and osmotic demyelination syndrome
Forest plot showing the association between rapid serum sodium correction and osmotic demyelination syndrome

Study characteristics

Trial (Study, Year) Number of patients Country Study design Inclusion criteria Rapid sodium correction definition Cases of ODS, n (%) Diagnosis of ODS
Sterns, 1987 62 USA Retrospective cohort Patients with serum sodium concentration of ≤110 mmol/L The rate of correction to increase the serum sodium to ≥120 mmol/L exceeds 0.55 mmol/L/h 3 (4.8) Postmortem examination, brainstem auditory evoked responses
Ellis, 1995 184 USA, UK Retrospective cohort All adult patients (≥16 years) with serum sodium ≤120 mmol/L at any stage of their hospitalization >10 mmol/L/24h 1 (0.5)a MRI
Vu, 2009 247 Australia Retrospective cohort All patients with serum sodium ≤120 mmol/L on admission >12 mmol/L within the first 24h 4 (1.6) MRI
Geogheghan, 2015 412 USA Retrospective cohort All hospitalized patients with serum sodium ≤120 mmol/L after correction for serum glucose >10 mmol/L/24h 1 (0.2) Clinically or radiographically confirmedb
George, 2018 1490 USA Retrospective cohort Adults ≥18 years of age admitted with an initial serum sodium <120mEq/L >8 mEq/L/24h, >10 mEq/L/24h, or >18 mEq/L/48hc 9 (0.6)d MRI
Mustajoki, 2023 363 Finland Retrospective cohort All patients admitted to the ED with plasma sodium concentrations <116 mmol/L >10 mmol/L/24h 5 (1.4) MRI
Seethapathy, 2023 3274 USA Retrospective cohort Patients (at least 18 years of age) hospitalized with serum sodium level <120mEq/L in the 24 hours preceding or 24 hours after the recorded time of admission >10 mEq/L/24h 7 (0.2) MRI