Hyponatremia among Sepsis Patients in the Critical Care Unit and its Association with the SOFA Score: A Cross-sectional Study

Introduction: Hyponatremia is a frequent electrolyte imbalance observed in critically-ill patients. The Sequential Organ Failure Assessment (SOFA) score is a tool used in sepsis management to assess the severity of organ dysfunction and predict mortality in critically-ill patients. Thus, establishing an association between hyponatremia and the SOFA score aids in triaging patients at high risk of mortality and enhancing management strategies. Aim: To estimate the prevalence of hyponatremia in sepsis patients hospitalised in the critical care unit and analyse its association with SOFA scores. Materials and Methods: The prospective observational crosssectional study was carried out at the Critical Care Unit of Smt. B. K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth Deemed to be University, Piparia, Waghodia, Gujarat, India over a one-month duration in November 2024 on 88 sepsis patients aged over 18 years. Following informed consent, routine investigations such as Arterial Blood Gas (ABG), serum bilirubin, platelet count, creatinine, and sodium levels were performed. SOFA scores were calculated at the time of admission, and the severity of hyponatremia was assessed. Statistical tests for prevalence and associations within the data were applied, and the Chi-square test with a p-value of less than 0.05 was considered statistically significant. Results: The mean age of study patients with hyponatremia was 50.74 years, with a standard deviation of 16.49 years. The majority of study participants were male, comprising 62.32%, while females accounted for 37.68%. Hyponatremia was observed in 78.4% of sepsis patients, with 39.8% exhibiting mild hyponatremia, 25% moderate hyponatremia, and 13.6% severe hyponatremia. A SOFA score of 2 was most frequent in 19 patients (27.5%), and the mean SOFA score was 4.42, with a standard deviation of 2.34. The three most common aetiological diagnoses for hyponatremia were lower respiratory tract infection, followed by decompensated Chronic Liver Disease (CLD) and acute ischaemic stroke with aspiration pneumonia. The association between the SOFA score and the severity of hyponatremia was statistically significant, as indicated by the Chi-square test (p<0.05). Additionally, a statistically significant association was observed between the severity of hyponatremia and specific components of the SOFA score, namely platelet count and serum creatinine. Conclusion: Hyponatremia is highly prevalent in critically-ill sepsis patients. The association between hyponatremia and SOFA scores highlights the need for timely diagnosis and management of hyponatremia to reduce morbidity and mortality.