Association of serum Sodium with mortality in patients of Congestive heart failure

  Objectives:  To determine the association of serum Sodium with mortality in patients of Congestive heart failure. Study Design: Prospective observational study Settings and Duration of study: Department of Medicine, Sir Ganga Ram Hospital, Lahore.  ( 22-12-2021 to 22-6-2022 ). Methods:  Sample size of 100 patients; 50 in each group in calculated with 90% power of study, 5% significance level and taking percentage of mortality i.e. 24.75% patients with low serum sodium level and in 4.21% patients with normal serum sodium level. Sample Selection: Inclusion Criteria: Patients aged between 30-70 years, both genders, Patients with congestive heart failure ,Group I: with serum sodium level <135 mEq/L, Group II: with serum sodium level ≥135 mEq/L. Exclusion Criteria: Liver disorders (AST>25IU, ALT>30IU, hepatitis B or C), renal disorders (eGFR ˂ 30 mL/min/1.73 m2 or creatinine >2.0mg/dl or on hemodialysis), any malignancy, anemia (Hb<9 g/dl), due to inherited hemoglobinopathy such as; sickle cell disease, and thalassemia, Patients with recurrent congestive heart failure or already taking treatment for deranged sodium level , valvular heart disease. Results: Patients in exposed group had 52% mortality rate as compared to unexposed group in which mortality rate was only 18% respective. Value of relative risk showed that patients in exposed group had 2.88 times higher chances of mortality as compared to those patients in unexposed group. Similarly, elderly patients (Relative Risk=3.23), Male patients (Relative Risk= 3.37), Overweight patients (Relative Risk=3.54), non-diabetic patients (Relative Risk=3.50), hypertensive patients (Relative Risk=2.95), ischemic heart disease patients (Relative Risk=4.12), Smoker (Relative risk=4.41) and duration of congestive HF as 0.5-3.5 (Relative Risk= 3.03) had higher risk for mortality. Conclusion: Results obtained from this study showed that low serum sodium level had significant impact on patients of congestive HF in terms of mortality. Keeping its prognostic importance, congestive HF patients should be strictly monitored for electrolyte imbalance. Key Words: Serum sodium, Prognostic, Indicator, Mortality,Congestive Heart Failure.