背景:在中国尚无关于慢性急性肝病(AoCLD)住院患者中不同Na水平的患病率及其与90天预后的关系的报道。因此,AoCLD患者纠正低钠血症的益处尚不清楚.
方法:我们前瞻性收集了来自中国CATCH-LIFE队列的3970例AoCLD患者的数据。分析不同Na水平(≤120;120-135;135-145;>145)的患病率及其与90天预后的关系。对于低钠血症患者,我们在第4天和第7天测量了Na水平,并比较了它们的特征,根据低钠血症是否得到纠正。
结果:共3880例患者参与,其中712例在90天内出现不良结局。有80例(2.06%)高钠血症,28(0.72%)严重低钠血症,入院时轻度低钠血症患者813例(20.95%)。在调整了所有混杂因素后,90天不良结局的风险降低了5%(比值比[OR]0.95;95%置信区间[CI]0.93-0.97;p<0.001),24%(OR0.76;95%CI0.70-0.84;p<0.001),和42%(OR0.58;95%CI0.49-0.70;p<0.001)随着Na水平增加1、5和10mmol/L,分别。在第4天和第7天未纠正低钠血症与2.05倍相关(风险比[HR],2.05;95%CI,1.50-2.79;p<0.001)和1.46倍(HR1.46;95%CI1.05-2.02;p=0.028)的不良后果风险更高。
结论:低钠血症是AoCLD患者90天预后不良的独立危险因素。入院后一周未能纠正低钠血症通常与死亡率增加有关。(ClinicalTrials.gov编号:NCT02457637,NCT03641872)。
背景:本研究在上海www注册。clinicaltrials.org(NCT02457637和NCT03641872)。
BACKGROUND: No reports exist regarding the prevalence of different Na levels and their relationship with 90-day prognosis in hospitalized patients with acute-on-chronic liver disease (AoCLD) in
China. Therefore, the benefit of hyponatremia correction in AoCLD patients remains unclear.
METHODS: We prospectively collected the data of 3970 patients with AoCLD from the CATCH-LIFE cohort in
China. The prevalence of different Na levels (≤ 120; 120-135; 135-145; > 145) and their relationship with 90-day prognosis were analyzed. For hyponatremic patients, we measured Na levels on days 4 and 7 and compared their characteristics, based on whether hyponatremia was corrected.
RESULTS: A total of 3880 patients were involved; 712 of those developed adverse outcomes within 90 days. There were 80 (2.06%) hypernatremic, 28 (0.72%) severe hyponatremic, and 813 (20.95%) mild hyponatremic patients at admission. After adjusting for all confounding factors, the risk of 90-day adverse outcomes decreased by 5% (odds ratio [OR] 0.95; 95% confidence interval [CI] 0.93-0.97; p < 0.001), 24% (OR 0.76; 95% CI 0.70-0.84; p < 0.001), and 42% (OR 0.58; 95% CI 0.49-0.70; p < 0.001) as Na level increased by 1, 5, and 10 mmol/L, respectively. Noncorrection of hyponatremia on days 4 and 7 was associated with 2.05-fold (hazard ratio [HR], 2.05; 95% CI, 1.50-2.79; p < 0.001) and 1.46-fold (HR 1.46; 95% CI 1.05-2.02; p = 0.028) higher risk of adverse outcomes.
CONCLUSIONS: Hyponatremia was an independent risk factor for a poor 90-day prognosis in patients with AoCLD. Failure to correct hyponatremia in a week after admission was often associated with increased mortality. (ClinicalTrials.gov number: NCT02457637, NCT03641872).
BACKGROUND: This study is registered at Shanghai www.clinicaltrials.org (NCT02457637 and NCT03641872).