J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 8, Number 2, February 2016, pages 141-146

Are the Dysnatremias a Permanent Threat to the Critically Ill Patients?

Figure 1. Receiver operating characteristic (ROC) curves of Acute Physiology and Chronic Health Evaluation II (APACHE II), serum sodium level on admission, sodium 48 h after admission and sodium at discharge of patient from ICU.

Figure 2. Boxplot of serial serum sodium levels (in mmol/L), distributed by groups of patients of survivors (S) and non-survivors (NS) for sodium admission (A), sodium 48 h (B) and sodium discharge (C).

**Table 1.** General Characteristics of the Surgical Patients Admitted to ICU*
	Patients (n = 195)	Survivors (n = 152)	Non-suvivors (n = 43)
*Values expressed as mean ± standard deviation.
Sex (M/F)	121/74	95/57	26/17
Age (years)	51.8 ± 17.1	51.5 ± 17.3	52.9 ± 16.8
APACHE II score	16.3 ± 8.3	13.6 ± 6.1	25.5 ± 8.5
Death risk (%)	25.3 ± 24.1	18 ± 17.3	50.6 ± 27.7
Mechanical ventilation (days)	2.6 ± 4.8	1.6 ± 3.6	6.13 ± 6.0
ICU length of stay (days)	4.3 ± 5.6	3.24 ± 3.8	8.2 ± 8.7
Hospital length of stay (days)	24 ± 21	23 ± 22	24 ± 20
ICU mortality (%)	22
Hospital mortality (%)	31.7
Oncologic surgery	61 (31.3%)	53 (27.2%)	8 (4.1%)
Non-oncologic surgery	134 (68.7%)	99 (50.7%)	35 (18%)
Cardiovascular	18 (9.3%)	13 (6.7%)	5 (2.5%)
Gastrointestinal	114 (58.5%)	86 (44.1%)	28 (14.4%)
Neurosurgery	6 (3%)	5 (2.5%)	1 (0.5%)
Orthopaedic	11 (5.6%)	11 (5.6%)	0
Thorax	19 (9.7%)	14 (7.2%)	5 (2.5%)
Obstetrics and gynecology	9 (4.6%)	9 (4.6%)	0
Urology	17 (8.7%)	13 (6.7%)	4 (2%)
Others	1 (0.5%)	1 (0.5%)	0

Table 1. General Characteristics of the Surgical Patients Admitted to ICU*

Patients (n = 195)

Survivors (n = 152)

Non-suvivors (n = 43)

*Values expressed as mean ± standard deviation.

Sex (M/F)

121/74

95/57

26/17

Age (years)

51.8 ± 17.1

51.5 ± 17.3

52.9 ± 16.8

APACHE II score

16.3 ± 8.3

13.6 ± 6.1

25.5 ± 8.5

Death risk (%)

25.3 ± 24.1

18 ± 17.3

50.6 ± 27.7

Mechanical ventilation (days)

2.6 ± 4.8

1.6 ± 3.6

6.13 ± 6.0

ICU length of stay (days)

4.3 ± 5.6

3.24 ± 3.8

8.2 ± 8.7

Hospital length of stay (days)

24 ± 21

23 ± 22

24 ± 20

ICU mortality (%)

Hospital mortality (%)

31.7

Oncologic surgery

61 (31.3%)

53 (27.2%)

8 (4.1%)

Non-oncologic surgery

134 (68.7%)

99 (50.7%)

35 (18%)

Cardiovascular

18 (9.3%)

13 (6.7%)

5 (2.5%)

Gastrointestinal

114 (58.5%)

86 (44.1%)

28 (14.4%)

Neurosurgery

6 (3%)

5 (2.5%)

1 (0.5%)

Orthopaedic

11 (5.6%)

Thorax

19 (9.7%)

14 (7.2%)

5 (2.5%)

Obstetrics and gynecology

9 (4.6%)

Urology

17 (8.7%)

13 (6.7%)

4 (2%)

Others

1 (0.5%)

**Table 2.** Comparison of Areas Under the Curve (AUC) of Receiver Operating Characteristic (ROC) for Different Predictors at ICU
Variable	AUC	95% CI	P value
Hypothesis test of diagnostic accuracy P < 0.05 (Wilcoxon test) [15].
APACHE II	0.841	0.782 - 0.889	0.03
Sodium admission (mmol/L)	0.721	0.653 - 0.783	0.04
Sodium 48 h (mmol/L)	0.754	0.687 - 0.812	0.04
Sodium discharge (mmol/L)	0.720	0.651 - 0.782	0.05

Table 2. Comparison of Areas Under the Curve (AUC) of Receiver Operating Characteristic (ROC) for Different Predictors at ICU

Variable

AUC

95% CI

P value

Hypothesis test of diagnostic accuracy P < 0.05 (Wilcoxon test) [15].

APACHE II

0.841

0.782 - 0.889

0.03

Sodium admission (mmol/L)

0.721

0.653 - 0.783

0.04

Sodium 48 h (mmol/L)

0.754

0.687 - 0.812

0.04

Sodium discharge (mmol/L)

0.720

0.651 - 0.782

0.05

**Table 3.** Distribution of Different Serum Sodium Levels Between Survivors and Non-Survivors Present on Admission of the Surgical Patient to ICU
Patients (n = 195)	Na < 136*	Na 136 - 144	Na > 144
*Values expressed as mmol/L.
Sex (M/F)	44/24	62/42	14/9
Age (years)	55 ± 13	50 ± 14	50 ± 13
APACHE II score	14 ± 5	21 ± 14	22 ± 6
Survivors	64	78	10
Non-survivors	4	26	13
n	68	104	23
Percentage (%)	34.8	53.4	11.7

Table 3. Distribution of Different Serum Sodium Levels Between Survivors and Non-Survivors Present on Admission of the Surgical Patient to ICU

Patients (n = 195)

Na < 136*

Na 136 - 144

Na > 144

*Values expressed as mmol/L.

Sex (M/F)

44/24

62/42

14/9

Age (years)

55 ± 13

50 ± 14

50 ± 13

APACHE II score

14 ± 5

21 ± 14

22 ± 6

Survivors

Non-survivors

104

Percentage (%)

34.8

53.4

11.7