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논문분류	춘계학술대회 초록집
제목	Prognostic Impact of Hyponatremia in Patients with Colorectal Cancer
저자	Joon Seok Choi1, Eun Hui Bae1, Seong Kwon Ma1, Sun Seog Kweon2,3, Soo Wan Kim1
출판정보	2014; 2014(1):
키워드	Colorectal cancer, Hyponatremia, Prognosis
초록	Background: Hyponatremia is a common electrolyte disorder associated with tumor-related conditions. However, the clinical impact of hyponatremia in patients with colorectal cancer has not been evaluated. Methods: We retrospectively assessed 2944 patients who had been admitted to Chonnam National University Hwasun Hospital with a diagnosis of colorectal cancer. In order to determine the relationship between serum sodium level and 3-year mortality, we categorized the patients according to the sodium level as having normonatremia (135-147 mEq/L) or mild (130-134 mEq/L), moderate (125-129 mEq/L), or severe hyponatremia (<125 mEq/L). Results: Hyponatremia, defined as a serum sodium level of <135 mEq/L, was evident in 27.6% of patients during hospitalization. Declining serum sodium levels were associated with increasing age, a higher number of comorbidities, a more advanced TNM stage, and worsening biochemical parameters. In a multivariate Cox-proportional regression analysis, the mortality risk was correlated with the severity of hyponatremia (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.38-1.96; HR: 2.24, 95% CI: 1.69-2.98; HR: 2.20, 95% CI: 1.25-3.90, for patients with mild, moderate, and severe hyponatremia compared with patients with normonatremia, respectively). An independent association between hyponatremia and long-term mortality was sustained among various subpopulations, and patients with persistent hyponatremia had a worse prognosis as compared those with hyponatremia that was resolved or acquired during hospitalization. Conclusion: A substantial proportion of patients developed hyponatremia during hospitalization, and the long-term mortality risk increased even in mild cases of hyponatremia. Hyponatremia should be considered as an important prognostic factor in patients with colorectal cancer.
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