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Hyponatremia is a predictor of hospital length and cost of stay and outcome in cancer patients

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Abstract

Purpose

Hyponatremia is the most common electrolyte disorder in hospitalized patients, and it might be an indicator of poor prognosis and might have negative effects on hospitalization length and quality of life in non-malignant as well as in malignant diseases. The aim of this study is to determine the impact of hyponatremia on the length and on the cost of hospitalization as well as on outcome in cancer patients.

Methods

The present study includes 105 consecutive cancer patients hospitalized at our institution from June 2013 to December 2013. Data regarding age, sex, staging, histology, chemotherapy, and serum sodium levels at admission, during hospitalization, and at discharge were recorded and statistically analyzed. Impact of hyponatremia on length and cost of hospitalization and on outcome was evaluated.

Results

A significant difference in overall survival since the date of admission was observed between eunatremic and hyponatremic patients (p = 0.0255). A statistically significant correlation was also found between the length of stay and the detection of hyponatremia. At multivariate analysis, hyponatremia at admission, severity of hyponatremia, and stage of disease resulted independent prognostic factors. Furthermore, a patient with moderate or severe hyponatremia cost, in rate terms, 128 and 299 % more than a normonatremic patient, respectively.

Conclusions

The occurrence of hyponatremia at the admission or during the hospitalization may represent a significant factor influencing the outcome and the length of hospitalization. Acting effective and timely on the normalization of sodium levels might have a positive effect on prognosis in this setting of patients, as well as on the length of stay in hospital, thus potentially resulting in savings.

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Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Conflict of interest

All authors disclose no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work or that could be perceived as prejudicing the impartiality of the research reported. The authors have full control of all primary data and do agree to allow the journal to review their data if requested.

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Authors and Affiliations

  1. Medical Oncology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I – Lancisi – Salesi di Ancona, Università Politecnica delle Marche, Via Conca 71, 60126, Ancona, Italy

    R. Berardi, M. Caramanti, M. Castagnani, F. Marcucci, A. Savini, F. Morgese, S. Rinaldi, C. Ferrini, M. Tiberi, M. Torniai, F. Rovinelli, I. Fiordoliva, A. Onofri & S. Cascinu

  2. Pharmacy, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I – GM Lancisi – G Salesi, Ancona, Italy

    S. Guglielmi

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  1. R. Berardi
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  2. M. Caramanti
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  3. M. Castagnani
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Corresponding author

Correspondence to R. Berardi.

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Berardi, R., Caramanti, M., Castagnani, M. et al. Hyponatremia is a predictor of hospital length and cost of stay and outcome in cancer patients. Support Care Cancer 23, 3095–3101 (2015). https://doi.org/10.1007/s00520-015-2683-z

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  • DOI: https://doi.org/10.1007/s00520-015-2683-z

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