U-shaped relationship between sodium levels and short-term mortality in Sepsis

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dc.contributor.authorAlpar, Suleyman
dc.contributor.authorTatliparmak, Ali Cankut
dc.date.accessioned2026-01-31T15:08:15Z
dc.date.available2026-01-31T15:08:15Z
dc.date.issued2025
dc.departmentİstanbul Beykent Üniversitesi
dc.description.abstractBackground: Dysnatremia is a common electrolyte disturbance among critically ill patients and may have important prognostic implications in the context of sepsis. This study aims to investigate the independent association between admission serum sodium abnormalities and 30-day mortality in patients with sepsis, and to evaluate the mortality risk across the full spectrum of sodium levels at emergency department (ED) presentation. Methods: This retrospective cohort study included adult patients diagnosed with sepsis in the ED of a tertiary care hospital between January 1, 2022, and January 1, 2025. Dysnatremia was defined as serum sodium <135 or > 145 mmol/L at admission. The primary outcome was 30-day all-cause mortality. Multivariate logistic regression and generalized additive modeling (GAM) were used to evaluate the association between serum sodium and mortality, adjusting for relevant clinical and laboratory covariates. Results: A total of 793 patients were included in the final analysis. The overall 30-day mortality rate was 23.0 %. Dysnatremia was independently associated with increased risk of 30-day mortality (adjusted OR: 4.06, 95 % CI: 1.67-10.19, p = 0.002). Additional predictors included elevated lactate, hsCRP, procalcitonin, and SOFA scores. The association between serum sodium and mortality exhibited a non-linear pattern, with both hypoand hypernatremic extremes showing higher mortality compared to the normonatremic range. The GAM model demonstrated strong discriminative performance (ROC-AUC: 0.893). Conclusion: Abnormal serum sodium levels at presentation were independently associated with short-term mortality in patients with sepsis. These findings support the inclusion of sodium measurements in early clinical assessment and risk stratification of septic patients in the ED. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
dc.identifier.doi10.1016/j.ajem.2025.08.003
dc.identifier.endpage232
dc.identifier.issn0735-6757
dc.identifier.issn1532-8171
dc.identifier.pmid40780072
dc.identifier.scopus2-s2.0-105012633760
dc.identifier.scopusqualityQ1
dc.identifier.startpage227
dc.identifier.urihttps://doi.org./10.1016/j.ajem.2025.08.003
dc.identifier.urihttps://hdl.handle.net/20.500.12662/10639
dc.identifier.volume97
dc.identifier.wosWOS:001560268400002
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherW B Saunders Co-Elsevier Inc
dc.relation.ispartofAmerican Journal of Emergency Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WoS_20260128
dc.subjectSepsis
dc.subjectDysnatremia
dc.subjectMortality
dc.subjectRisk stratification
dc.subjectGeneralized additive modeling
dc.subjectMachine learning
dc.titleU-shaped relationship between sodium levels and short-term mortality in Sepsis
dc.typeArticle

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