Samsca May be Particularly Beneficial for Heart Failure Patients Readmitted with Hyponatremia
In Samsca, Hyponatremia
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By: Saparja Nag Apr. 19, 2018
Samsca was developed by Otsuka Pharmaceutical to treat hyponatremia as a selective vasopressin V2-receptor antagonist. It is only suitable for cases of euvolemic and hypervolemic hyponatremia; an explanation of the condition can be found in a previous article. Hyponatremia can be caused by a number of conditions including Syndrome of Inappropriate Antidiuretic Hormone (SIADH) and heart failure. The specific relationship between hyponatremia and heart failure has been studied extensively. Hyponatremia patients with heart failure often present with an increased circulating neurohormones such as angiotensin II, renin, catecholamines, and vasopressin. When a patient has heart failure, their cardiac output and circulating blood volume decrease causing the body to compensate in order to preserve blood pressure, thus increasing water and sodium retention.
Several studies have examined the cause and effect relationship between lowered serum sodium levels and heart failure. One study conducted by researchers at Northwestern University’s Feinberg School of Medicine discovered a significant association between in-hospital mortality of patients with sodium levels between 135-138 mmol/L and patients with HF. Scientists at King’s College London GKT School of Medicine found that mean serum sodium concentration levels below 138 mmol/L can be a predictor of mortality due to pump failure in patients with mild to moderate heart failure. Another study, from Duke Clinical Research Institute, determined that persistent hyponatremia is a predictor of mortality, heart failure hospitalization, and death, thereby increasing risk for adverse events.
DRG-292: Heart Failure with Complication or Comorbidity was the primary focus on this analysis as they had the highest 30-day hyponatremia readmission rates, particularly compared to the overall readmission rates for all Medicare inpatients. DRG-292 patients at Covenant Medical Center had a readmission rate with hyponatremia of 3.2%, whereas all inpatients with hyponatremia had a readmission rate of 2.54% of the same hospital. Yuma Regional Medical Center saw 3.93% of DRG-292 patients with hyponatremia readmitted within 30 days, while they saw 2.49% of all inpatients with hyponatremia readmitted. The readmission rate for DRG-292 patients with hyponatremia at Anne Arundel Medical Center was 2.89%, but only 1.56% for all Medicare inpatients with hyponatremia. These metrics suggest that heart failure patients with hyponatremia are more likely to be readmitted than all Medicare inpatients who present with hyponatremia. Samsca may prove to be particularly beneficial for these HF patients with hyponatremia who are more likely to be readmitted with further medical issues than the general population.
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- Discharge volume and 30-day hyponatremia readmission rates for heart failure DRGs (DRG-291, 292, 293) at Covenant Medical Center, Yuma Regional Medical Center, and Anne Arundel Medical Center
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