Impact of Iatrogenic, Excessive, Nondietary Sodium Administration in Patients with Acute Heart Failure Exacerbation on Hospital Length of Stay

• Published in: Pharmacotherapy 2011-01, Vol.31 (1), p.58-61
• Main Authors: Tafreshi, Javad, Hoang, Thu M., Grigorian, Tomik, Pai, Ajit D., Tafreshi, Ali R., Pai, Ramdas G.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cardiology. Vascular system; Comorbidity; Dyslipidemias - epidemiology; Female; Heart; heart failure; Heart Failure - epidemiology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; hospital stay; Hospitalization; Humans; Hypertension - epidemiology; Length of Stay; Male; Medical sciences; Middle Aged; outcomes; Pharmacology. Drug treatments; Retrospective Studies; Sodium - administration & dosage; sodium load; Time Factors; Young Adult
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1592/phco.31.1.58

Study Objective. To investigate the sources and quantities of nondietary sodium administration in patients hospitalized for acute heart failure exacerbation, and to evaluate the impact of sodium administration on length of stay. Design. Retrospective analysis. Setting. University‐affiliated medical center. Patients. One hundred and eighty‐two consecutive patients admitted to a cardiac intensive care unit for acute heart failure exacerbation between January 1 and June 30, 2009. Measurements and Main Results. Drug therapy profiles of all patients were reviewed for sources and quantities of nondietary sodium administration, and the impact of sodium administration on hospital stay was analyzed. The mean ± SD nondietary sodium load was 4.0 ± 5.0 g/day. The predominant sources of sodium were intravenous 0.9% or 0.45% sodium chloride. The daily amount of sodium administration was directly related to the duration of hospital stay, with an average sodium load of 1.2 g/day correlating with hospital stays of up to 5 days, and an average of 2.6 g/day correlating with hospital stays of up to 10 days. Conclusion. We observed excessive sodium administration in patients hospitalized for acute exacerbation of heart failure. We speculate that reducing sodium administration in these patents may reduce length of hospital stay and cost of hospitalization.