Unveiling the influence of hyponatremia on morbidity, mortality, and resource utilization in colorectal carcinoma: Insights from a 5-year nationwide study.

Abstract

e15657 Background: Historically, Hyponatremia has been associated with higher mortality rates and longer hospital stays in patients with solid tumors. The existing literature contains limited information on the connection between hyponatremia and Colorectal cancer (CRC). Thus, our study aimed to assess the impact of hyponatremia on mortality, morbidity, and resource usage in patients with CRC. Methods: A retrospective analysis using the National Inpatient Sample database and International Classification of Diseases, Tenth Revision codes was conducted to examine the impact of hyponatremia on mortality, morbidity, and resource utilization in patients with CRC. Categorical variables were compared using chi-square tests, while continuous variables were compared using t-tests. Multivariable regression analyses were performed, adjusting for demographics, hospital-level characteristics, and relevant comorbidities. Confounding variables were adjusted using multivariate logistic and linear regression analyses. These included gender, race, Charlson Comorbidity Index, chronic kidney disease, congestive heart failure, cirrhosis, nephrotic syndrome, hypothyroidism, adrenal insufficiency, alcohol use disorder, and admission for hypovolemia or psychogenic polydipsia and various patient and hospital characteristics. Results: A total of 337,190 patients with a primary diagnosis of colon cancer were included in the study, of which 12.6% (3,369) presented with hyponatremia (Table 1). The in-hospital mortality rate was 7.8% for patients with hyponatremia, compared to 4.1% for patients without hyponatremia. After adjusting for confounding factors, hyponatremia was found to significantly increase the odds of mortality (adjusted odds ratio [aOR] for mortality 1.85, 95% confidence interval [CI]: 1.68–2.03, P < 0.01). Patients with colon cancer and hyponatremia also had higher odds of developing sepsis (OR = 2.60), acute kidney injury (OR = 2.63), peritonitis (OR = 2.25), and ICU admission (OR = 2.12) (Table 1). Additionally, hyponatremia was associated with increased resource utilization, as evidenced by a longer mean length of stay and higher mean total hospital charges. Conclusions: This retrospective analysis demonstrated that hyponatremia significantly increases mortality, morbidity, and resource utilization in individuals with CRC. Patients with colorectal cancer and hyponatremia have substantially higher mortality rates, underscoring the importance of monitoring sodium levels and implementing appropriate interventions to prevent and manage this electrolyte imbalance. The high incidence rates of sepsis, acute kidney injury, and peritonitis, along with frequent ICU admissions, provide further evidence of the negative impact of hyponatremia on patient outcomes.