HEART FAILURE CLINICAL OUTCOMES IN HYPONATREMIC VERSUS NORMONATREMIC PATIENTS

Abstract

Objective: To compare the outcome in heart failure patients between normonatremic and hyponatremic cases in the short term.

Methodology: A cross-sectional study focusing on descriptive statistics atthe Department of Cardiology, Lady Reading Hospital Peshawar was performedfrom 9th August 2011, till 29th April, 2012. Both male and femalepatients aged 14 years and above admitted diagnosed with heart failure wereenrolled and data observed. Those having serum sodium of ≤135mmol/Lwere defined as hyponatremic. All the patients were managed according toguidelines. All patients were followed during their hospital stay. Patients whosurvived were discharged on standard HF medications and followed till theend of third month for 3 month mortality and re-admissions for heart failure.

Results: Total study population was 241. Mean age was 59.2 ± 14.9 (18-100) years. Female patients were 51% (123). Mean serum sodium was136±5.1mmol/L (116-151). Hyponatremia was present in 35.3% (85) patients.Overall three month follow up mortality was 14.7%, while it was significantlyhigher in hyponatremic group 22.7% compared to normonatremic patients10.7% (P=0.02). Being followed for a period of 3 months 25% patients werereadmitted to hospital with heart failure decompensation. Hyponatremicgroup had readmission rate of 26.7% compared with 24% in normonatremicpatients (p=0.74).

Conclusions: Hyponatremia in patients diagnosed with heart failure possessa significant over all risk to a higher mortality as compared to those that arenormonatremic. Re-admissions for heart failure are equally common in hyponatremic and normonatremic patients.