Hyponatremia Improvement Is Associated with a Reduced Risk of Mortality: Evidence from a Meta-Analysis
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{"title"=>"Hyponatremia improvement is associated with a reduced risk of mortality: Evidence from a meta-analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Giovanni", "last_name"=>"Corona", "scopus_author_id"=>"7006699184"}, {"first_name"=>"Corinna", "last_name"=>"Giuliani", "scopus_author_id"=>"36848691800"}, {"first_name"=>"Joseph G.", "last_name"=>"Verbalis", "scopus_author_id"=>"7006448070"}, {"first_name"=>"Gianni", "last_name"=>"Forti", "scopus_author_id"=>"7102220586"}, {"first_name"=>"Mario", "last_name"=>"Maggi", "scopus_author_id"=>"7102422617"}, {"first_name"=>"Alessandro", "last_name"=>"Peri", "scopus_author_id"=>"7003594594"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84928408851", "sgr"=>"84928408851", "pui"=>"603953490", "pmid"=>"25905459", "doi"=>"10.1371/journal.pone.0124105"}, "id"=>"7613d6c9-9aea-3819-8e71-938028c7c612", "abstract"=>"BACKGROUND Hyponatremia is the most common electrolyte disorder and it is associated with increased morbidity and mortality. However, there is no clear demonstration that the improvement of serum sodium concentration ([Na(+)]) counteracts the increased risk of mortality associated with hyponatremia. Thus, we performed a meta-analysis that included the published studies that addressed the effect of hyponatremia improvement on mortality. METHODS AND FINDINGS A Medline, Embase and Cochrane search was performed to retrieve all English-language studies of human subjects published up to June 30th 2014, using the following words: \"hyponatremia\", \"hyponatraemia\", \"mortality\", \"morbidity\" and \"sodium\". Fifteen studies satisfied inclusion criteria encompassing a total of 13,816 patients. The identification of relevant abstracts, the selection of studies and the subsequent data extraction were performed independently by two of the authors, and conflicts resolved by a third investigator. Across all fifteen studies, any improvement of hyponatremia was associated with a reduced risk of overall mortality (OR=0.57[0.40-0.81]). The association was even stronger when only those studies (n=8) reporting a threshold for serum [Na(+)] improvement to >130 mmol/L were considered (OR=0.51[0.31-0.86]). The reduced mortality rate persisted at follow-up (OR=0.55[0.36-0.84] at 12 months). Meta-regression analyses showed that the reduced mortality associated with hyponatremia improvement was more evident in older subjects and in those with lower serum [Na(+)] at enrollment. CONCLUSIONS This meta-analysis documents for the first time that improvement in serum [Na(+)] in hyponatremic patients is associated with a reduction of overall mortality.", "link"=>"http://www.mendeley.com/research/hyponatremia-improvement-associated-reduced-risk-mortality-evidence-metaanalysis-1", "reader_count"=>18, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Researcher"=>3, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>2, "Other"=>1, "Student > Master"=>1, "Student > Bachelor"=>6}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Researcher"=>3, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>2, "Other"=>1, "Student > Master"=>1, "Student > Bachelor"=>6}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Engineering"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>12, "Agricultural and Biological Sciences"=>2}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>12}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>2}}, "group_count"=>0}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2038008"], "description"=>"<p>* = threshold for serum [Na<sup>+</sup>] improvement <u>></u>130 mmol/L.</p><p>HN: hyponatremia; HF: heart failure; SCLC: small cell lung cancer; APE: acute pulmonary embolism; MI; myocardial infarction.</p><p>Observational studies included in the meta-analysis.</p>", "links"=>[], "tags"=>["mortality", "na", "serum", "hyponatremia improvement"], "article_id"=>1393056, "categories"=>["Uncategorised"], "users"=>["Giovanni Corona", "Corinna Giuliani", "Joseph G. Verbalis", "Gianni Forti", "Mario Maggi", "Alessandro Peri"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0124105.t001", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Observational_studies_included_in_the_meta_analysis_/1393056", "title"=>"Observational studies included in the meta-analysis.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-23 04:02:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038006"], "description"=>"<p>Odds ratio for overall mortality rate in patients with any increase of serum [Na<sup>+</sup>].</p>", "links"=>[], "tags"=>["mortality", "na", "serum", "hyponatremia improvement"], "article_id"=>1393054, "categories"=>["Uncategorised"], "users"=>["Giovanni Corona", "Corinna Giuliani", "Joseph G. Verbalis", "Gianni Forti", "Mario Maggi", "Alessandro Peri"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0124105.g003", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Odds_ratio_for_overall_mortality_rate_in_patients_with_any_increase_of_serum_Na_/1393054", "title"=>"Odds ratio for overall mortality rate in patients with any increase of serum [Na<sup>+</sup>].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-23 04:02:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038003"], "description"=>"<p>Trial flow diagram.</p>", "links"=>[], "tags"=>["mortality", "na", "serum", "hyponatremia improvement"], "article_id"=>1393051, "categories"=>["Uncategorised"], "users"=>["Giovanni Corona", "Corinna Giuliani", "Joseph G. Verbalis", "Gianni Forti", "Mario Maggi", "Alessandro Peri"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0124105.g001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Trial_flow_diagram_/1393051", "title"=>"Trial flow diagram.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-23 04:02:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038010", "https://ndownloader.figshare.com/files/2038011"], "description"=>"<div><p>Background</p><p>Hyponatremia is the most common electrolyte disorder and it is associated with increased morbidity and mortality. However, there is no clear demonstration that the improvement of serum sodium concentration ([Na<sup>+</sup>]) counteracts the increased risk of mortality associated with hyponatremia. Thus, we performed a meta-analysis that included the published studies that addressed the effect of hyponatremia improvement on mortality.</p><p>Methods and Findings</p><p>A Medline, Embase and Cochrane search was performed to retrieve all English-language studies of human subjects published up to June 30<sup>th</sup> 2014, using the following words: “hyponatremia”, “hyponatraemia”, “mortality”, “morbidity” and “sodium”. Fifteen studies satisfied inclusion criteria encompassing a total of 13,816 patients. The identification of relevant abstracts, the selection of studies and the subsequent data extraction were performed independently by two of the authors, and conflicts resolved by a third investigator. Across all fifteen studies, any improvement of hyponatremia was associated with a reduced risk of overall mortality (OR=0.57[0.40-0.81]). The association was even stronger when only those studies (n=8) reporting a threshold for serum [Na<sup>+</sup>] improvement to >130 mmol/L were considered (OR=0.51[0.31-0.86]). The reduced mortality rate persisted at follow-up (OR=0.55[0.36-0.84] at 12 months). Meta-regression analyses showed that the reduced mortality associated with hyponatremia improvement was more evident in older subjects and in those with lower serum [Na<sup>+</sup>] at enrollment.</p><p>Conclusions</p><p>This meta-analysis documents for the first time that improvement in serum [Na<sup>+</sup>] in hyponatremic patients is associated with a reduction of overall mortality.</p></div>", "links"=>[], "tags"=>["mortality", "na", "serum", "hyponatremia improvement"], "article_id"=>1393058, "categories"=>["Uncategorised"], "users"=>["Giovanni Corona", "Corinna Giuliani", "Joseph G. Verbalis", "Gianni Forti", "Mario Maggi", "Alessandro Peri"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0124105.s001", "https://dx.doi.org/10.1371/journal.pone.0124105.s002"], "stats"=>{"downloads"=>7, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Hyponatremia_Improvement_Is_Associated_with_a_Reduced_Risk_of_Mortality_Evidence_from_a_Meta_Analysis_/1393058", "title"=>"Hyponatremia Improvement Is Associated with a Reduced Risk of Mortality: Evidence from a Meta-Analysis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-04-23 04:02:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038004"], "description"=>"<p>Funnel plot of the observational studies included in the meta-analysis.</p>", "links"=>[], "tags"=>["mortality", "na", "serum", "hyponatremia improvement"], "article_id"=>1393052, "categories"=>["Uncategorised"], "users"=>["Giovanni Corona", "Corinna Giuliani", "Joseph G. Verbalis", "Gianni Forti", "Mario Maggi", "Alessandro Peri"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0124105.g002", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Funnel_plot_of_the_observational_studies_included_in_the_meta_analysis_/1393052", "title"=>"Funnel plot of the observational studies included in the meta-analysis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-23 04:02:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038009"], "description"=>"<p>Studies that met inclusion criteria but did not provide data for meta-analysis.</p>", "links"=>[], "tags"=>["mortality", "na", "serum", "hyponatremia improvement"], "article_id"=>1393057, "categories"=>["Uncategorised"], "users"=>["Giovanni Corona", "Corinna Giuliani", "Joseph G. Verbalis", "Gianni Forti", "Mario Maggi", "Alessandro Peri"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0124105.t002", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Studies_that_met_inclusion_criteria_but_did_not_provide_data_for_meta_analysis_/1393057", "title"=>"Studies that met inclusion criteria but did not provide data for meta-analysis.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-23 04:02:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2038007"], "description"=>"<p>Odds ratio for overall mortality rate in patients from studies in which a threshold for serum [Na<sup>+</sup>] improvement >130 mmol/L was reported.</p>", "links"=>[], "tags"=>["mortality", "na", "serum", "hyponatremia improvement"], "article_id"=>1393055, "categories"=>["Uncategorised"], "users"=>["Giovanni Corona", "Corinna Giuliani", "Joseph G. Verbalis", "Gianni Forti", "Mario Maggi", "Alessandro Peri"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0124105.g004", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Odds_ratio_for_overall_mortality_rate_in_patients_from_studies_in_which_a_threshold_for_serum_Na_improvement_gt_130_mmol_L_was_reported_/1393055", "title"=>"Odds ratio for overall mortality rate in patients from studies in which a threshold for serum [Na<sup>+</sup>] improvement >130 mmol/L was reported.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-23 04:02:08"}

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{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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