Jung et al identified risk factors for in-hospital mortality for a patient admitted with community-acquired hypernatremia (CAH). These can help to identify a patient who may benefit from more aggressive management. The authors are from Soonchunhyand University in Seoul, South Korea.

Patient selection: admission with community-acquired hypernatremia (serum sodium > 147 mEq/L), not transferred from another hospital


Risk factors for in-hospital mortality:

(1) moderate or severe hypernatremia at maximal concentration (peak)

(2) admission from the Emergency Department

(3) restriction on oral intake (dietary restriction)

(4) low mean arterial blood pressure at admission

(5) increased respiratory rate at admission


Serum Sodium

Severity of Hypernatremia

148 to 150 mEq/L


151 to 154 mEq/L


>= 155 mEq/L



The more risk factors that were present the greater the length of stay and the higher the in-hospital mortality.

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