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Lookup NU author(s): Professor Miles WithamORCiD
This is the authors' accepted manuscript of an article that has been published in its final definitive form by Taylor and Francis Ltd, 2019.
For re-use rights please refer to the publisher's terms and conditions.
© 2018, © 2018 Medisinsk Fysiologisk Forenings Forlag (MFFF). Our aim was to explore biological variation of serum sodium levels as a method of quantifying health risk in older adults. We investigated whether dynamic changes in serum sodium levels could provide additional prognostic information to standard predictors of mortality in older people. Analysis of routinely collected clinical datasets containing information on demographics, hospitalisation, biochemistry, haematology and physical function for Dundee in-patient rehabilitation services, between 1999 and 2011. Older people admitted to inpatient rehabilitation following an acute medical or surgical hospitalisation. Five dynamic measures of sodium levels homeostasis–minimum, maximum, standard deviation, and minimum and maximum deviation from mean–were derived for each individual, using biochemistry data from the year preceding their rehabilitation discharge. Cox regression models tested for associations with time to death. Covariates included age, sex, discharge Barthel score, co-morbid diagnoses, haemoglobin, albumin and eGFR. 3021 patients were included (mean age 84 years, 1776 (58.8%) females). 1651 (54.7%) patients experienced hyponatraemia and 446 (14.8%) became hypernatraemic. Mean sodium was correlated with all mean, minimum and SD of sodium. Kaplan–Meier survival curves showed that those without sodium perturbations had the best mortality outcomes, whilst those with both hyponatremia and hypernatremia had the worst. Multivariate Cox regression showed that standard deviation and hypernatraemia were significant predictors of death in non-adjusted models, but not fully adjusted models. All dynamic measures of dysnatraemia were associated with increased mortality risk, but failed to add predictive value to established static measures after adjusting for covariates.
Author(s): Barma MA, Soiza RL, Donnan PT, McGilchrist MM, Frost H, Witham MD
Publication type: Article
Publication status: Published
Journal: Scandinavian Journal of Clinical and Laboratory Investigation
Year: 2019
Volume: 78
Issue: 7-8
Pages: 632-638
Online publication date: 03/01/2019
Acceptance date: 30/10/2018
Date deposited: 19/02/2019
ISSN (print): 0036-5513
ISSN (electronic): 1502-7686
Publisher: Taylor and Francis Ltd
URL: https://doi.org/10.1080/00365513.2018.1543893
DOI: 10.1080/00365513.2018.1543893
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