Prevalence, classification and factors associated with hyponatremia in patients hospitalized in the clinical service of Hospital José Carrasco Arteaga, Cuenca, 2019

Abstract

BACKGROUND: Hyponatremia is the most frequent hydroelectrolytic disorder; it has multiple etiologies, and it is important to study in order to define an adequate treatment. Thus the aim of this study is to determine the prevalence, classification and factors associated with hyponatremia in patients hospitalized in the clinical service of Hospital José Carrasco Arteaga. METHODS: an observational, cross-sectional, analytical study was carried out with a sample of 347 patients, calculated with 95% confidence, 10% prevalence, inference error of 3%, in a population of 1 426 patients. Data was obtained from the institutional medical system (AS400) and analyzed with PSPP software. To determine the prevalence, hyponatremia was considered with sodium less than 135mEq/l, which was corrected according to glucose value. We calculated the prevalence ratio with a 95% confidence interval, statistical significance was estimated when p value was <0.05. RESULTS: the average age was 62 years, the female sex represented 53.3% of the sample. The prevalence of hyponatremia was 25.9%. According to severity, mild forms represented 72.22%, moderate 16.67% and severe 11.11%; in terms of osmolarity, 98.89% were hypotonic. Associated factors with hyponatremia were: decompensated hypothyroidism (PR: 3.39, 95% CI = 2.42 - 4.75, p= < 0.001), liver cirrhosis (PR: 3.18, 95% CI = 2.25 - 4.48, p= < 0.001), kidney failure (PR: 2.46, 95% CI = 1.70 - 3.55, p= < 0.001), disorders that produce third space: sepsis or pancreatitis (PR: 2.00, 95% CI = 1.29 - 3.09, p = 0.006) and use of diuretics (PR: 1.86, 95% CI = 1.29 - 2.68, p = 0.001). CONCLUSION: a quarter of the hospitalized patients presented hyponatremia, the mild form was the most frequent. Hyponatremia had a statistically significant association with decompensated hypothyroidism, liver cirrhosis, kidney failure, disorders that produce third space and use of diuretics.