Hypernatremia at admission predicts poor survival in patients with terminal cancer: a retrospective cohort study.

ABSTRACT: BACKGROUND:Although palliative care providers, patients, and their families rely heavily on accurate prognostication, the prognostic value of electrolyte imbalance has received little attention. METHODS: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. RESULTS: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. CONCLUSION:Hypernatremia may be a useful gauge of prognosis in patients with terminal cancer. Further large-scale prospective studies are needed to corroborate this finding.

SUBMITTER: Seo MS 

PROVIDER: S-EPMC7331249 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature