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Hypernatremia at admission predicts poor survival in patients with terminal cancer: a retrospective cohort study.
BMC Palliative Care ( IF 2.5 ) Pub Date : 2020-07-01 , DOI: 10.1186/s12904-020-00607-z
Min-Seok Seo 1, 2 , In Cheol Hwang 3 , Jaehun Jung 4 , Hwanhee Lee 3 , Jae Hee Choi 3 , Jae-Yong Shim 2
Affiliation  

Although palliative care providers, patients, and their families rely heavily on accurate prognostication, the prognostic value of electrolyte imbalance has received little attention. As a retrospective review, we screened inpatients with terminal cancer admitted between January 2017 and May 2019 to a single hospice-palliative care unit. Clinical characteristics and laboratory results were obtained from medical records for multivariable Cox regression analysis of independent prognostic factors. Of the 487 patients who qualified, 15 (3%) were hypernatremic upon admission. The median survival time was 26 days. Parameters associated with shortened survival included male sex, advanced age (> 70 years), lung cancer, poor performance status, elevated inflammatory markers, azotemia, impaired liver function, and hypernatremia. In a multivariable Cox proportional hazards model, male sex (hazard ratio [HR] = 1.53, 95% confidence interval [CI]: 1.15–2.04), poor performance status (HR = 1.45, 95% CI: 1.09–1.94), leukocytosis (HR = 1.98, 95% CI: 1.47–2.66), hypoalbuminemia (HR = 2.06, 95% CI: 1.49–2.73), and hypernatremia (HR = 1.55, 95% CI: 1.18–2.03) emerged as significant predictors of poor prognosis. Hypernatremia may be a useful gauge of prognosis in patients with terminal cancer. Further large-scale prospective studies are needed to corroborate this finding.

中文翻译:

一项回顾性队列研究表明,入院时高钠血症预示着晚期癌症患者的不良生存。

尽管姑息治疗提供者,患者及其家人严重依赖准确的预后,但电解质紊乱的预后价值却鲜为人知。作为回顾性回顾,我们对2017年1月至2019年5月期间收治的晚期癌症住院患者进行了单一临终关怀治疗单位的筛查。从医疗记录中获得临床特征和实验室结果,以对独立的预后因素进行多变量Cox回归分析。在487名合格患者中,有15名(3%)入院时出现高钠血症。中位生存时间为26天。与缩短生存期相关的参数包括男性,高龄(> 70岁),肺癌,不良的工作状态,炎性标志物升高,氮质血症,肝功能受损和高钠血症。在多变量Cox比例风险模型中,男性(风险比[HR] = 1.53,95%置信区间[CI]:1.15-2.04),表现不佳(HR = 1.45,95%CI:1.09-1.94),白细胞增多(HR = 1.98,95%CI:1.47–2.66),低白蛋白血症(HR = 2.06,95%CI:1.49–2.73)和高钠血症(HR = 1.55,95%CI:1.18–2.03)成为贫困人口的重要预测指标预后。高钠血症可能是晚期癌症患者预后的有用指标。需要进一步的大规模前瞻性研究来证实这一发现。03)成为不良预后的重要预测指标。高钠血症可能是晚期癌症患者预后的有用指标。需要进一步的大规模前瞻性研究来证实这一发现。03)成为不良预后的重要预测指标。高钠血症可能是晚期癌症患者预后的有用指标。需要进一步的大规模前瞻性研究来证实这一发现。
更新日期:2020-07-01
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