Readmissions Reduced with Outpatient Provider Awareness of Inpatient Hyponatremia

Orlando—Hospitalized patients often experience hyponatremia, which is associated with increased risk of mortality. Previous studies have demonstrated the prognostic significance of hyponatremia; however, outpatient providers are often not informed of a hyponatremia diagnosis upon hospital discharge.

Researchers, led by Gordon J. Hildick-Smith, BA, conducted a retrospective cohort study designed to examine the association of communicating inpatient hyponatremia to outpatient providers and the rate of hospital readmission. Results of the study were reported during a poster session at the NKF 2017 Spring Clinical Meetings in a poster titled Communication of Inpatient Hyponatremia to Outpatient Providers Is Associated with Fewer Hospital Readmissions.

The study included patients admitted to the Weill Cornell Campus of the New York-Presbyterian Hospital in January 2014. Inclusion criteria were serum sodium level <130 mEq/L and survival to discharge of the index hospitalization.

The researchers reviewed discharge summaries for documentation of hyponatremia; electronic medical records were reviewed to obtain clinical data. The chi-square test or Fisher’s exact test were used to assess the association between categorical variables. Continuous variables were tested with the Kruskal Wallis test (Wilcoxon Rank Sum Test).

The cohort included 48 patients with 1 year of follow-up data. Hyponatremia was communicated to outpatient providers in 38% of cases. Compared with patients who did not have hyponatremia communicated to their outpatient provider, those who did have that information communicated had fewer readmissions within one year (1.5 vs 1 readmissions, P<.04).

There were no differences between the two groups in initial serum sodium, mortality, or visits to the emergency department at 1 year. Patients with communicated hyponatremia had lower discharge sodium levels than those without communicated hyponatremia (131.5 mEq/L vs 135 mEq/L, P<.01).

“Communication of hyponatremia to outpatient providers is more likely when the discharge sodium level is lower, and is associated with fewer hospital readmissions,” the researchers said.

Source: Hildick-Smith GJ, Srivagana V, Salline K, Silberzweig JI. Communication of inpatient hyponatremia to outpatient providers is associated with fewer hospital readmissions. Abstract of a poster presented at the National Kidney Foundation 2017 Spring Clinical Meetings, April 19-22, 2017, Orlando, Florida.