Effect of fosfomycin-induced hypernatremia on patients' hospital stay length and survival.

Abstract

Hypernatremia is a possible side effect of intravenous fosfomycin. The aim of this study was to investigate the effects of changes in sodium (Na) levels on hospital stay and survival in patients hospitalized in the intensive care unit receiving fosfomycin. This study was conducted retrospectively on the files of patients over the age of 60, who were admitted to the Internal Medicine Intensive Care Unit. Plasma sodium levels were observed and documented over a period of 14days. The patients were divided into two groups (Hypernatremia group Na > 145 mEq/L vs normonatremia group 135-145mEq/L). In addition, daily sodium changes were noted for 14days in patients. The mean age of the patients was 75years. Hospitalization days were longer for hypernatremia patients (31.5days vs 41days, p = 0.003). Patients with hypernatremia had an extended duration of stay in the intensive care unit. (21days vs 31days p = 0.002). The 1-month survival rate was 61.4% in patients with hypernatremia and 24.9% in patients without hypernatremia (p = 0.004). The absence of hypernatremia increases mortality by 2.09 times (95% CI 1.35-3.23). When discharge and mortality rates were analyzed according to sodium fluctuation, discharged patients exhibited a lower sodium fluctuation (4min/max (-10/19) vs 6min/max (-16/32) p < 0.001). In conclusion, the strength of our study is that it specifically focuses on the consequences of the sodium fluctuation on patient management and provides results.