Prognostic relevance of hyponatremia after first-ever ischemic stroke
 
More details
Hide details
1
Department of Neurology, Medical University of Silesia in Katowice, Hospital No. 7, Professor Leszek Giec Upper Silesian Medical Centre, Katowice, Poland
 
2
Department of Internal Medicine and Metabolic Disease, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
 
3
Faculty of Physiotherapy – Institute of Rehabilitation Medicine, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
 
4
Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
 
 
Corresponding author
Michał Holecki   

Department of Internal Medicine and Metabolic Disease, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, ul. Ziołowa 45-47, 40-635 Katowice, Poland, tel. 32 359 82 23
 
 
Ann. Acad. Med. Siles. 2016;70:127-132
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Hyponatremia is examined as a prognostic factor after first-time ischemic cerebrovascular incident (CVA, ischemic stroke).

Material and methods:
677 patients were analyzed after first-time ischemic stroke and divided into two groups according to sodium concentration: ≤ 135 mmol/L and > 135 mmol/L.

Results:
For patients with sodium levels ≤ 135 mmol/L, the median National Institutes of Health Stroke Scale (NIHSS) score was 5 points, the median Modified Rankin Scale (mRS) was 4 points, and the mortality within 1 month of ischemic stroke was 10.5%. Patients with sodium levels > 135 mmol/L: NIHSS 3 points, mRS 2 points and mortality 1 month after ischemic stroke 3.4%. Mortality within 1 month of ischemic stroke in hyponatremic patients: women 16.4%, men 3.5% (p = 0.0194). Greater disability was seen in eunatremic women as assessed by increased mRS scores (p = 0.005).

Conclusions:
Hyponatremia is associated with a worsened heath status in patients in the acute and sub-acute phase after first-time ischemic stroke and is associated with increased mortality within 1 month after the stroke. Women with hyponatremia were characterized by greater mortality within one month after their first-ever ischemic stroke. In women with normal serum sodium at the time of stroke, a higher degree of disability was observed as assessed by increased mRS scores compared to men.

 
REFERENCES (18)
1.
Neurologia Merritta. Red. L.P. Rowland, red. wyd. pol. H. Kwieciński, A.M. Kamiński. Urban & Partner. Wrocław 2008; 280–357.
 
2.
Neurologia. Red. A. Stępień. Medical Tribune Polska. Warszawa 2014, 171–215.
 
3.
Spasovski G. Vanholder R. Allolio B., Annane D., Ball S., Bichet D., Decaux G., Fenske W., Hoorn E.J., Ichai C., Joannidis M., Soupart A., Zietse R., Haller M., van der Veer S., Van Biesen W., Nagler E. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol. Dial. Transplant. 2014; 29. Suppl. 2: i1–i39.
 
4.
Anderson R.J., Chung H.M., Kluge R., Schrier R.W. Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann. Intern. Med. 1985; 102: 164–168.
 
5.
Hawkins R.C. Age and gender as risk factors for hyponatremia and hypernatremia. Clin. Chim. Acta 2003; 337(1–2): 169–172.
 
6.
Upadhyay A., Jaber B.L., Madias N.E. Epidemiology of hyponatremia. Semin. Nephrol. 2009; 29: 227–238.
 
7.
Sajadieh A. Binici Z., Mouridsen M., Nielsen O.W., Hansen J.F., Haugaard S.B. Mild hyponatremia carries a poor prognosis in community subjects. Am. J. Med. 2009; 122: 679–686.
 
8.
Bussmann C., Bast T., Rating D. Hyponatraemia in children with acute CNS disease: SIADH or cerebral salt wasting? Childs Nerv. Syst. 2001; 17(1–2): 58–62.
 
9.
Rabinstein A. Wijdicks E. Hyponatremia in critically ill neurological patients. Neurologist 2003; 9: 290–300.
 
10.
Alam M., Uddin M., Rahmn F., Ahmed S., Akhter M., Nahar N., Swapan M.K., Alam M.M., Sultana N., Hallaz M.M., Alam M.M., Uddin M.M., Bari M.S., Israil M.A. Electrolyte changes in stroke. Mymensingh Med. J. 2012; 21: 594–599.
 
11.
Wannamethee G., Whincup P.H., Shaper A.G., Lever A.F. Serum sodium concentration and risk of stroke in middle-aged males. J. Hypertens. 1994; 12(8): 971–979.
 
12.
Goldberg A., Hammerman H., Petcherski S., Nassar M., Zdorovyak A., Yalonetsky S., Kapeliovich M., Agmon Y., Beyar R., Markiewicz W., Aronson D. Hyponatremia and long-term mortality in survivors of acute ST-elevation myocardial infarction. Arch. Intern. Med. 2006; 166(7): 781–786.
 
13.
Bettari L., Fiuzat M., Felker G., O’Connor C.M. Significance of hyponatremia in heart failure. Heart Fail Rev. 2012; 17(1): 17–26.
 
14.
Lee S.H., Kim B.J., Ryu W.S., Kim C.K., Kim N., Park B.J., Yoon B.W. White matter lesions and poor outcome after intracerebral hemorrhage: a nationwide cohort study. Neurology 2010; 74(19): 1502–1510.
 
15.
Perkovic V., Cass A. Glomerular filtration rate and the risk of stroke. BMJ 2010; 341: c4390.
 
16.
Saleem S., Yousuf I., Gul A., Gupta S., Verma S. Hyponatremia in stroke. Ann. Indian. Acad. Neurol. 2014; 17: 55–57.
 
17.
Tanneau R.S., Henry A., Rouhart F., Bourbigot B., Garo B., Mocquard Y. Goas J.Y. High incidence of neurologic complications following rapid correction of severe hyponatremia in patients polydipsic. J. Clin. Psychiatry 1994; 55(8): 349–354.
 
18.
Roquer J., Campello A.R., Gomis M. Sex differences in first-ever acute stroke. Stroke 2003; 34(7): 1581–1585.
 
eISSN:1734-025X
Journals System - logo
Scroll to top