Factors Associated with Hyponatremia in Cirrhotic Patients at Campus Teaching Hospital Lome-Togo

Abstract

Objective : To identify the factors associated with hyponatremia in cirrhotic patients hospitalised in the gastroenterology and hepatology department of the Campus Teaching Hospital of Lomé (Togo). Patients and Method : This was a descriptive and analytical cross-sectional study with retrospective data collection from January 2019 to July 2023 and prospective data collection from August 2023 to December 2023, i . e ., a study period of 5 years. The study population consisted of cirrhotic patients aged over 18 years who were hospitalised. Logistic regression was used to identify factors associated with the occurrence of hyponatremia. Results : This study enabled us to identify 332 cirrhotic patients, 105 of whom had hyponatremia (natremia ≤ 130 mmol/L), i . e ., a frequency of 31.6%. Among patients with hyponatremia, ascites (61.9%) and abdominal pain (41.9%) were the most frequent reasons for hospitalisation. Alcoholism (55.2%) and traditional treatment (33.3%) were the most common antecedents in these patients. The most frequent complications were ascitic decompensation and hepatic encephalopathy in 90.5% and 63.8% respectively. The treatment received was dominated by isotonic saline infusion (70.5%). Clinical outcome was death in 61 patients, a mortality rate of 58.1%. The length of hospitalisation for patients with hyponatremia ranged from 0 to 37 days, with an average of 10.54 days ± 7.96 days. The factors associated with hyponatremia were hepatic encephalopathy (aOR = 1.29, CI 95% [1.06 - 2.61], p = 0.0051), acute renal failure (aOR = 1.4, CI 95% [1.11 - 3.19], p = 0.0027), and Child-Pugh C score (aOR = 2.46, CI 95% [1.73 - 3.02], p = 0.034). Conclusion : Hyponatremia is one of the most feared complications of cirrhosis because it is a poor prognostic factor in cirrhotic patients.