Hiponatremia como factor relacionado a mortalidad en pacientes con cirrosis hepática internados en el Hospital Teodoro Maldonado Carbo durante el periodo 2018-2019.

Abstract

Background: Liver cirrhosis represents the final stage of a process of continuous attacks on the liver parenchyma of multiple etiologies, which also represents one of the most important causes for liver transplantation and mortality in our environment. On the other hand, hyponatremia is a frequent complication in cirrhotic patients that has been associated with high morbidity and mortality. The present study seeks to associate hyponatremia with mortality in our patients with liver cirrhosis. Methods: A retrospective, observational and cross-sectional study was carried out, where the sample included 198 patients with the diagnosis of liver cirrhosis, the data were collected through the review of medical records in the AS400 system at the Hospital Teodoro Maldonado Carbo during the period from January 2018 to December 2019, entered for tabulation in Microsoft Excel and processed in the STATA 16.0 program. Results: A total of 198 cirrhotic patients were studied, 122 presented hyponatremia (61.62%). The mean serum sodium was 127.07 mEq/dL with a SD 7.27. 82 patients died of which 62 presented hyponatremia (p = 0.001) (OR: 2.89 1.49-5.69). The patients who presented hyponatremia on the Child-Pugh scale were: Child A: 39.37%, Child B: 62.04% and Child C: 75%. Complications in hyponatremic patients were: ascites in 53.28% (p = 0.929), esophageal varices in 50.82% (p = 0.864), variceal bleeding in 34.43% (p = 0.874), jaundice in 19.67. % (p = 0.049), hepatic encephalopathy (p = 0.001) and hepatorenal syndrome (p = 0.019) both with 36.89%. Conclusion: In this study, it was concluded that there is a statistically significant association between mortality and hyponatremia, since mortality was higher in decompensated cirrhotic patients with hyponatremia, and it is also related to a higher degree of severity according to the Child-Pugh scale. It was also determined that hyponatremic patients had a shorter hospital stay on average (8.7 days compared to non-hyponatremic patients who were 9.3 days on average). In addition to this, it was shown that the presence of hyponatremia is related to certain serious complications such as hepatic encephalopathy and hepatorenal syndrome.