TITLE:
Post-Hospital Syndrome and Hyponatremia
AUTHORS:
José Bellod-Tonda, Julio Blázquez-Encinar, María Dolores Jover-Ríos, Carmen Seguí-Pérez, Juan Méndez-Mora, Francisco Caparrós-Hernández, Álex Méndez-Jover, Marc Seguí-Pérez, David Baláž, Leticia Espinosa del Barrio, Jesús Corbacho-Redondo, Carles García-Cervera, Juan Manuel Núñez-Cruz, Isidro Hernández-Isasi, Javier Guzmán-Martínez, Angie Gómez-Uranga, Pedro Esteve-Atiénzar, Jorge Peris-García, Veronica Martínez-Sempere, Eliana Damonte-White, Óscar Hernando Ruiz-Ariza, Juan Carlos López-Corbalán, Lourdes Lajara-Villar, Andrea Riaño-Pérez, Paloma Chazarra-Pérez, María Escamilla-Espínola, Maria Luisa Asensio-Tomás, Miguel Ángel Auladell-Alemany, Laura Serna-Torres, Asunción Pérez-Fullana, Amparo Gómez-Siurana, Sergio Menargues-Irles, José Miguel Seguí-Ripoll
KEYWORDS:
Hospitalization, Hyponatremia, Patient Readmission, Inappropriate ADH Syndrome
JOURNAL NAME:
Health,
Vol.13 No.8,
August
20,
2021
ABSTRACT: Introduction: Post-hospital syndrome (PHS) is defined as a period of vulnerability during the first 30 days after a patient is discharged from hospital, in which multiple factors come into play. Hyponatremia is the most frequent hydroelectrolytic disorder in hospitalized patients and may be related to the appearance of PHS. Objective: The objective is to estimate the prevalence of PHS that is assessed as the rate of readmissions in the first 30 days after discharge, in patients with hyponatremia. Material and Methods: It is a descriptive observational study of patients with hyponatremia who were discharged from 1 September 2010 to 2 February 2020 at the Internal Medicine Service of the Hospital University of San Juan (Alicante, Spain). Results: Of the 25 included patients, 5 (20%) were readmitted within a month of discharge, after a mean of 11.4 days (standard deviation [SD] 5.1). The overall mortality of the study was 20% (n = 5), with one case of death in the first 30 days post-hospitalization (4%). In 12 patients (48%) the origin of the hyponatremia was undetermined. The most frequently recorded etiology for the condition was pharmacological (n = 7, 28%), and there was pronounced variability in its clinical and laboratory study. The most widely used corrective measure was drug withdrawal, in 16 patients (64%). Water intake restriction was the most common treatment after discharge (5 patients, 20%), followed by urea (2 patients, 8%), while tolvaptan was not used. Conclusion: Hyponatremia may be the cause of PHS, which could increase the rate of early readmission. Hyponatremia is an underdiagnosed and undertreated entity, so it is necessary to apply an appropriate system to optimize its management and, in future studies, to assess its impact on PHS.