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Background: Hyponatremia is the most common electrolyte disorder among hospitalized patients. Controversies still exist over the relationship between hyponatremia and outcomes of hospitalized patients. Methods: To analyze the association of low serum sodium levels at hospital admission with in-hospital mortality and patient disposition and to compare the distribution of the risk of death associated with hyponatremia across the lifespan of hospitalized patients, we conducted an observational study of 2.3 million patients using data extracted from the Cerner Health Facts database between 2000 and 2014. Logistic regression models were used in the analyses. Results: 14.4% of hospitalized patients had serum sodium levels [Na]/L. In adjusted multinomial logistic regression analysis, we found that the risk of in-hospital mortality significantly increases for [Na] levels < 135 or ≥143 to ≤145 mEq/L compared to the reference interval of 140 toConclusions:Hyponatremia is common among hospitalized patients and is independently associated with in-hospital mortality, discharge to hospice or to a nursing facility. The risk of death and other outcomes was more evident for [Na]/L. The mortality associated with low [Na] was significantly higher in younger versus older patients.


Submitted in partial fulfillment for the requirements for the degree of Master of Science in Biomedical Science, Clinical Research Concentration (MSCR)