Relationship between Serum Sodium Levels and Length of Hospital Stay in Patients with Pulmonary Hypertension associated with Left Heart Disease
Background Pulmonary hypertension(PH)associated with left heart disease(PH-LHD)is the most common form of PH.Studies have shown that serum sodium is associated with the severity and poor prognosis of group 1 PH,but the effect of serum sodium on PH-LHD has rarely been reported.Objective To investigate the relationship between serum sodium and N-terminal pro-brain natriuretic peptide(NT-proBNP)and echocardiographic indexes in PH-LHD patients,and evaluate the effect of serum sodium on the severity and length of stay of PH-LHD,so as to provide theoretical basis for clinical diagnosis and treatment of PH-LHD patients and improvement of hospital turnover.Methods The clinical data of 360 adult inpatients diagnosed with PH-LHD in the First Hospital of Shanxi Medical University from January 2020 to February 2022 were collected.According to the median serum sodium of 139 mmol/L(serum sodium<135 mmol/L is hyposodium),the patients were divided into 3 groups:<135 mmol/L group(n=50),135-139 mmol/L group(n=136)and 140-145 mmol/L group(n=174).Spearman correlation analysis was used to explore the correlation of serum sodium level with length of hospital stay,NT-proBNP and echocardiographic indicators.Kaplan-Meier was used to compare the length of hospital stay of PH-LHD patients with different serum sodium levels.Binary Logistic regression analysis was used to investigate the effect of serum sodium levels on the length of hospital stay in PH-LHD patients.Results Age,length of stay,NT-proBNP,left atrial diameter,right atrium area,left ventricular ejection fraction and shortening fraction of PH-LHD patients in 3 groups were compared,and the differences were statistically significant(P<0.05).The length of hospitalization and NT-proBNP of patients in the serum sodium 140-145 mmol/L group were lower than those in the serum sodium<135 mmol/L group and the serum sodium 135-139 mmol/L group(P<0.05).Spearman correlation analysis showed that serum sodium level was negatively correlated with length of stay(rs=-0.176),NT-proBNP(rs=-0.135),right ventricular diameter(rs=-0.110)and pulmonary artery systolic pressure(rs=-0.105)in PH-LHD patients(P<0.05).The Kaplan-Meier survival showed that there were statistically significant differences between the length of hospital stay among the three groups of PH-LHD patients with different serum sodium levels.Binary Logistic regression analysis showed that increased serum sodium level was a protective factor for longer hospital stay in PH-LHD patients after correcting each control variable(OR=0.916,95%CI=0.859-0.977,P=0.008).The risk of prolonged hospitalization was elevated in patients with serum sodium<135 mmol/L and those with serum sodium 135-139 mmol/L compared with patients with serum sodium 140-145 mmol/L.Conclusion Serum sodium level is closely related to the severity of PH-LHD,and decreased serum sodium level is an independent risk factor for the length of hospital stay in PH-LHD patients.It is a potential therapeutic consideration,providing new strategies for the diagnosis and treatment of PH-LHD and hospital turnover.
Pulmonary arterial hypertensionPulmonary hypertension associated with left heart diseaseSerum sodiumEchocardiographyLength of stayLogistic models
万方数据
维普
