The relation between hyponatremia at presentation, severity of disease and length of stay in patients with bronchiolitis

Abstract

Aim: In this study, we aimed to investigate the relationship between hyponatremia at presentation and severity of disease and length of stay in children admitted to hospital with acute bronchiolitis.

Material and Methods: This cross-sectional study was performed at a tertiary care hospital between May 2017 and April 2018. One hundred seventy children aged 1-24 months admitted with a diagnosis of acute bronchiolitis were included in the study. Demographic and biochemical data were recorded together with data associated with clinical course and length of stay.

Results: Hyponatremia was present in 62 (36.4%) of the 170 patients. Thirteen patients (20.9%) in the hyponatremic group were diagnosed with moderate bronchiolitis and 17 (27.5%) with severe bronchiolitis, while in the normonatremic group, 14 (12.9%) with moderate bronchiolitis and 9 (8.4%) with severe bronchiolitis (p<0.001). High-flow nasal cannula (FNC) requirement was present in 17 patients in the hyponatremic group and 17 in the normonatremic group (p=0.001). The risk of development of severe bronchiolitis increased 0.085-fold in patients with hyponatremia. The median length of hospitalization was 5 (221) days in the hyponatremic group and 4 (2-11) days in the normonatremic group (p=0.001). Hyponatremia increased length of stay approximately 4.7-fold.

Discussion: The risk of developing severe bronchiolitis and non-invasive mechanical ventilation requirements was significantly higher in the hyponatremic group. The length of hospital stay was greater in cases of bronchiolitis with hyponatremia. We think that measuring sodium levels during hospitalization in cases of bronchiolitis will be useful in predicting the risk of development of severe bronchiolitis and extended length of stay.