Avinash Hanbe Rajanna1, Swetha Rajoli2, Nitish Ashok Gurav3
BACKGROUND
Community acquired pneumonia (CAP) refers to pneumonia contracted by a
person with little or no contact with health care system. Severity scores like CURB
65 severity score are useful in estimating the outcome. Hyponatremia is defined
as serum sodium level < 135 mEq/L. The incidence of hyponatremia at hospital
admission among CAP patients is found to be 28 %and the mechanism behind it
has been found to be due to syndrome of inappropriate antidiuretic hormone
secretion (SIADH). Hence this study is an effort to explore how hyponatremia is
associated with severity and outcomes, in hospitalized patients with pneumonia.
The purpose of this study was to assess the proportion of hyponatremia in patients
with community acquired pneumonia and compare hyponatremia with CURB-65
as an initial screening tool for assessment of severity of CAP.
METHODS
This is a hospital-based cross-sectional study. 75 community acquired pneumonia
patients admitted as inpatients are included in this study. Information is collected
and detailed history is taken using pre-formed proforma at the time of admission.
Serum sodium levels were measured, after initial assessment of patients. The lab
values of serum sodium levels were analysed with the clinical profile and outcome
in these study groups.
RESULTS
In our study, it was observed that as the sodium levels are decreasing, the CURB
65 score increases. Study subjects who had sodium levels < 125 mg/dl, presented
with CURB 65 score as 4 (30 %). Inversely, the study subjects with high sodium
levels (> 135 mg/dl) had CURB 65 scores as 1 (75 %). The association between
sodium levels and CURB 65 score was significant in patients who got discharged
but not in patients who expired.
CONCLUSIONS
Present study of serum sodium levels as biomarkers in CAP showed that
hyponatremia carried poor prognosis which correlated with high CURB 65 score.
