Este estudio examina el impacto de diferentes tasas de corrección de sodio en los desenlaces de pacientes con hiponatremia grave (sodio sérico ≤ 120 mEq/L). La hiponatremia es una condición en la que los niveles de sodio en sangre son peligrosamente bajos, y su tratamiento debe manejarse cuidadosamente para evitar complicaciones. Las guías estándar recomiendan corregir los niveles de sodio lentamente para prevenir una condición neurológica rara pero grave denominada síndrome de desmielinización osmótica (ODS). Sin embargo, evidencia reciente sugiere que una tasa más rápida de corrección de sodio puede reducir la duración de la hospitalización y la mortalidad sin aumentar el riesgo de ODS. Este estudio retrospectivo, realizado entre 2010 y 2023 en un hospital de Buenos Aires, Argentina, compara los desenlaces de pacientes cuyo nivel de sodio fue corregido rápidamente (≥ 8 mEq/L en 24 horas) con aquellos que tuvieron correcciones más lentas. Los desenlaces primarios medidos son la mortalidad y el desarrollo de ODS.
This study focuses on the exposure to different sodium correction rates in patients with severe hyponatremia (serum sodium ≤ 120 mEq/L) rather than an active intervention. The two key groups are defined by their rate of sodium correction during the first 24 hours of hospitalization: Rapid Sodium Correction: An increase in serum sodium of ≥ 8 mEq/L within 24 hours. Slow Sodium Correction: An increase in serum sodium of \< 8 mEq/L within 24 hours. The primary objective is to assess the association between these exposure rates and clinical outcomes, including in-hospital mortality, 30-day mortality, and the incidence of osmotic demyelination syndrome (ODS). This study differs from others by using a large, retrospective cohort of patients treated in a real-world clinical setting, spanning 13 years (2010-2023), and applying robust statistical adjustments such as propensity score analysis to control for confounders.
This study focuses on the exposure to different sodium correction rates in patients with severe hyponatremia (serum sodium ≤ 120 mEq/L) rather than an active intervention. The two key groups are defined by their rate of sodium correction during the first 24 hours of hospitalization: Rapid Sodium Correction: An increase in serum sodium of ≥ 8 mEq/L within 24 hours. Slow Sodium Correction: An increase in serum sodium of \< 8 mEq/L within 24 hours. The primary objective is to assess the association between these exposure rates and clinical outcomes, including in-hospital mortality, 30-day mortality, and the incidence of osmotic demyelination syndrome (ODS). This study differs from others by using a large, retrospective cohort of patients treated in a real-world clinical setting, spanning 13 years (2010-2023), and applying robust statistical adjustments such as propensity score analysis to control for confounders.
Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina