By: James Pitt  May. 10, 2018
Hyponatremia, a low concentration of sodium in the blood, is a common and important electrolyte imbalance. Causes of hyponatremia include heart failure - and it is particularly common in heart failure patients.
Dexur analysts examined how hyponatremia and heart failure with major complications (DRG 291) affect mortality, using data derived from CMS inpatients at hospitals in Maryland with over 5,000 patients per year. Eleven hospitals reported mortality rates at DRG 291 and mortality rates excluding hyponatremia at DRG 291.
Hyponatremia did not increase mortality among DRG 291 patients at four hospitals: Suburban Hospital (Bethesda, MD), Saint Agnes Hospital (Baltimore, MD), Peninsula Regional Medical Center (Salisbury, MD), and Medstar Franklin Hospital Center (Baltimore, MD). In the remaining seven, hyponatremia did increase mortality among DRG 291 patients.
In addition to the three hospitals where hyponatremia seemed to have no effect on DRG 291 mortality, there were three hospitals where it seemed to have an unusually strong effect. The difference in mortality rate with and without hyponatremia was 5% at UM Baltimore Washington Medical Center, 8% at Anne Arundel Medical Center, and 19% at The Johns Hopkins Hospital. This exceeds the state average difference.
Anne Arundel and Johns Hopkins have the largest CMS inpatient discharge volumes in the state. These hospitals may face unique challenges among this patient population that smaller hospitals do not experience.