GIÁ TRỊ TIÊN LƯỢNG TỬ VONG, TÁI NHẬP VIỆN CỦA HẠ NATRI MÁU TRÊN BỆNH NHÂN SUY TIM PHÂN SUẤT TỐNG MÁU GIẢM VÀ GIẢM NHẸ

Abstract

Objective: To determine the prevalence and short-term prognostic value of hyponatremia in hospitalized patients with heart failure. Subjects and Methods: A prospective cohort study was conducted on 176 patients admitted with heart failure at University Medical Center Ho Chi Minh City from October 2024 to March 2025. Patients were stratified according to serum sodium levels on admission and followed for 90-day outcomes, including all-cause mortality and hospital readmission. Results: The mean age was 71 (62-82) years; 51.7% were male. The prevalence of hyponatremia was 36.4%, mostly mild. At 90 days, mortality was 4.0%, readmission 39.2%, and composite events 43.2%. There was no significant difference in composite outcomes between hyponatremia and non-hyponatremia groups (15.3% vs. 27.8%, p = 0.875). Severe hyponatremia (≤130 mmol/L) was an independent predictor of composite outcomes in multivariate logistic regression (adjusted OR 4.20; 95% CI: 1.57-11.25; p = 0.004), but not in Cox regression. History of coronary artery disease was a stronger predictor (HR 1.87; 95% CI: 1.09-3.22; p = 0.024). Conclusions: Hyponatremia is common in hospitalized patients with heart failure. Although it was not associated with higher composite outcomes, serum sodium ≤ 30 mmol/L remained an independent short-term prognostic factor in logistic regression