The usefulness of natrium concentrations in the evaluation of indications for hospitalization in children with pneumonia
Journal Title: Postępy Nauk Medycznych - Year 2014, Vol 27, Issue 9
Abstract
Introduction. Community-acquired pneumonia (CAP) is an important health concern that often requires hospitalization, especially in children under five years of age. Among indications for hospital treatment, Polish recommendations include water and electrolyte disorders, however, they do not specify their level. The aim of the study was to assess the frequency of hyponatremia (HN) in children hospitalized due to CAP and its correlation with other indications for hospital treatment.Materials and methods. The study included 146 patients (71 female, 75 male) aged 13 days to 17 years and 5 months (median age 36.5 months) hospitalized due to CAP in 2013. The diagnosis of pneumonia was confirmed by a chest x-ray. The frequency of hyponatremia (natrium concentrations below 136 mmol/L) was assessed, as well as its correlations with other indications for hospitalization, i.e., tachycardia, tachypnea, reduced oxygen saturation in capillary blood, leukocytosis, pleural reaction, increased serum inflammatory markers and a severe course of the pneumonia (sepsis, circulatory insufficiency, neurological symptoms).Results. HN was present in 43% of patients; in the majority (97%) it was mild. Patients with HN were at a higher risk (5.7-fold increased risk, 95% CI: 2.1-15.6, p = 0.0007) of high procalcitonin values (above 2 ng/mL), with AUC (the area under curve) = 0.74 (95% CI: 0.62-0.85). For the cut-off value of HN (135 mmol/L) the sensitivity was 77% and the specificity 64%, while the negative prognostic value was 92%. A correlation with other indications for hospitalization was not observed.Conclusions. Natrium concentration measurement should be a routine procedure in patients hospitalized due to CAP and the occurrence of HN may suggest a risk of a more severe course of the disease.
Authors and Affiliations
August Wrotek, Teresa Jackowska, Karolina Czekaj-Kucharska
Keywords
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