Hyponatremia is the most frequently encountered electrolyte abnormality in critically ill patients. Hyponatremia on admission has been identified as an independent predictor of in-hospital mortality in patients with spontaneous intracerebral hemorrhage (sICH). However, the incidence and etiology of hyponatremia (HN) during hospitalization in a neurointensive care unit following spontaneous intracerebral hemorrhage (sICH) remains unknown. This was a retrospective analysis of consecutive patients admitted to Detroit Receiving Hospital for sICH between January 2006 and July 2009. All serum Na levels were recorded for patients during the ICU stay. HN was defined as Na <135 mmol/L. A total of 99 patients were analyzed with HN developing in 24% of sICH patients. Patients with HN had an average sodium nadir of 130 ± 3 mmol/L and an average time from admission to sodium <135 mmol/L of 3.9 ± 5.7 days. The most common cause of hyponatremia was syndrome of inappropriate antidiuretic hormone (90% of HN patients). Patients with HN were more likely to have fever (50% vs. 23%; p = 0.01), infection (58% vs. 28%; p = 0.007) as well as a longer hospital length of stay (14 (8–25) vs. 6 (3–9) days; p < 0.001). Of the patients who developed HN, fifteen (62.5%) patients developed HN in the first week following sICH. This shows HN has a fairly high incidence following sICH. The presence of HN is associated with longer hospital length of stays and higher rates of patient complications, which may result in worse patient outcomes. Further study is necessary to characterize the clinical relevance and treatment of HN in this population.
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机译：低钠血症是危重患者中最常见的电解质异常。入院时低钠血症已被确定为自发性脑出血（sICH）患者住院死亡率的独立预测因子。然而，自发性脑内出血（sICH）后神经重症监护病房住院期间低钠血症（HN）的发生率和病因仍未知。这是对2006年1月至2009年7月在底特律接收医院接受sICH的连续患者的回顾性分析。在ICU住院期间记录了患者的所有血清Na水平。 HN被定义为Na <135 mmol / L。在24％的sICH患者中分析了总共99例HN发生的患者。 HN患者的平均钠最低值为130±3 mmol / L，入院至钠<135 mmol / L的平均时间为3.9±5.7天。低钠血症的最常见原因是抗利尿激素不当综合征（HN患者的90％）。 HN患者更容易发烧（50％比23％； p = 0.01），感染（58％比28％； p = 0.007）以及住院时间更长（14（8–25） ）vs. 6（3–9）天； p <0.001）。在发生HN的患者中，有15名（62.5％）患者在sICH后的第一周内发生了HN。这表明HN在sICH后发生率很高。 HN的存在与更长的住院时间和更高的患者并发症发生率相关，这可能导致患者预后更差。进一步的研究对于表征该人群中HN的临床相关性和治疗很有必要。
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