Risk factors for hyponatremia in acute exacerbation chronic obstructive pulmonary disease (AECOPD): a multicenter cross-sectional study

作者全名："Xiao, Min; Wang, Xiaoyu; Wang, Hanchao; Du, Fawang; Yao, Yu; Wang, Xiaochuan; Wang, Jiajia; Yang, Juan; Xiong, Wei; Wang, Qin; Ren, Xubin; Zhu, Tao"

作者地址："[Xiao, Min] Sichuan Univ, West China Hosp, Resp Med & Crit Care Med, Chengdu 610041, Peoples R China; [Wang, Xiaoyu] Sichuan Univ, West China Hosp, Otolaryngol Head & Neck Surg, Chengdu 610041, Peoples R China; [Wang, Hanchao; Du, Fawang; Yao, Yu; Wang, Xiaochuan; Zhu, Tao] Suining Cent Hosp, Preclin Res Ctr, Resp Med & Crit Care Med, Suining 629000, Sichuan, Peoples R China; [Wang, Jiajia] Chongqing Med Univ, Affiliated Hosp 2, Rheumatol Med, Chongqing 400010, Peoples R China; [Yang, Juan] Mayo Clin, Div Gen Internal Med, Rochester, MN 55905 USA; [Xiong, Wei; Wang, Qin] Chongqing Med Univ, Affiliated Hosp 2, Resp Med & Crit Care Med, Chongqing 400010, Peoples R China; [Ren, Xubin] Chengdu First Peoples Hosp, Resp Med & Crit Care Med, Chengdu 610041, Sichuan, Peoples R China"

通信作者："Zhu, T (通讯作者)，Suining Cent Hosp, Preclin Res Ctr, Resp Med & Crit Care Med, Suining 629000, Sichuan, Peoples R China."

来源：BMC PULMONARY MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000918704200001

JCR分区：Q2

影响因子：2.6

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Acute exacerbation chronic obstructive pulmonary disease (AECOPD); Hyponatremia; Risk factors; Least absolute shrinkage and selection operator (LASSO) regression; Nomogram

摘要："BackgroundHyponatremia is an independent predictor of poor prognosis, including increased mortality and readmission, in COPD patients. Identifying modifiable etiologies of hyponatremia may help reduce adverse events in patients with AECOPD. Therefore, the aim of this study was to explore the risk factors and underlying etiologies of hyponatremia in AECOPD patients.MethodsA total of 586 AECOPD patients were enrolled in this multicenter cross-sectional study. Finally, 323 had normonatremia, and 90 had hyponatremia. Demographics, underlying diseases, comorbidities, symptoms, and laboratory data were collected. The least absolute shrinkage and selection operator (LASSO) regression was used to select potential risk factors, which were substituted into binary logistic regression to identify independent risk factors. Nomogram was built to visualize and validate binary logistics regression model.ResultsNine potential hyponatremia-associated variables were selected by LASSO regression. Subsequently, a binary logistic regression model identified that smoking status, rate of community-acquired pneumonia (CAP), anion gap (AG), erythrocyte sedimentation rate (ESR), and serum magnesium (Mg2+) were independent variables of hyponatremia in AECOPD patients. The AUC of ROC curve of nomogram was 0.756. The DCA curve revealed that the nomogram could yielded more clinical benefits if the threshold was between 10% and 52%.ConclusionsCollectively, our results showed that smoking status, CAP, AG, ESR, and serum Mg2+ were independently associated with hyponatremia in AECOPD patients. Then, these findings indicate that pneumonia, metabolic acidosis, and hypomagnesemia were the underlying etiologies of hyponatremia in AECOPD patients. However, their internal connections need further exploration."

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