Undercorrection of hypernatremia is frequent and associated with mortality

BMC Nephrology

Table 4 Factors associated with death during hospitalization: univariate and multivariate analysis using a Cox regression model (n = 78)

	Monovariate analysis			Multivariate analysis
	p	HR	CI 95%	p	Adjusted HR	CI 95%
Age	0.04	1.05	1.00-1.10
Male gender	0.06	2.47	0.97-6.28	0.007	5.65	1.60-19.90
Place of origin and personal environment:
Home	Ref.	Ref.	Ref.
Institution or home medical care	0.65	1.24	0.50-3.08
Season of occurrence:
Winter	Ref.	Ref.	Ref.
Spring	0.36	0.54	0.15-2.00
Summer	0.79	0.86	0.29-2.59
Autumn	0.21	0.38	0.08-1.75
Dementia	0.54	1.40	0.48-4.04
Treatment modifying renal water excretion	0.95	1.04	0.32-3.33
Characteristics at admission:
Systolic blood pressure (mmHg) †	<0.001	0.97	0.95-0.98
Diastolic blood pressure (mmHg) †	0.001	0.95	0.92-0.98
Mean blood pressure	<0.001	0.95	0.92-0.97	<0.001	0.92	0.91-1.06
Neurologic symptoms	0.03	5.22	1.20-22.78
Extracellular dehydration	0.07	4.02	0.92-17.63
Natremia (mmol/L)	0.88	1.01	0.94-1.07	0.64	0.98	0.88-0.95
Calculated plasmatic tonicity (mOsm/L) †	0.06	1.02	1.00-1.04
Calculated plasmatic osmolarity (mOsm/L)	0.09	1.02	1.00-1.03
Creatinine (μmol/L)	0.004	1.01	1.00-1.01
eGFR (mL/min/1.73 m²) †	0.03	0.98	0.95-1.00
Main diagnosis in emergency department:
Extracellular dehydration	Ref.	Ref.	Ref.
Infection	0.04	4.21	1.09-16.29
Other
Perfused solute:	0.18	2.46	0.67-9.10
Hypotonic solute	Ref.	Ref.	Ref.
Isotonic solute, no perfusion or unknown	0.44	1.43	0.58-3.52
Natremia correction speed:
Mean speed between entry and last known natremia (mmol/L/h) †	0.10	18.79	0.59-597.13
No natremia improvement	0.02	3.12	1.22-7.96	<0.001	10.29	3.12-33.96

Factors indicated by † were not included in the multivariate analysis because a linked factor was already included in the analysis.

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