IMPACT OF HYPONATREMIA ON CLINICAL OUTCOMES, RECOVERY, AND MORTALITY IN STROKE PATIENTS

Background: Low sodium levels in the blood, known as Hyponatremia is a usual electrolyte ailment in stroke patients and may contribute to adverse clinical outcomes. Objective: This study evaluates the impact of hyponatremia on functional recovery, hospital mortality, and hospital stay in stroke patients. Methods: This multicentre prospective study was carried out at three medical universities from July to December 2024. A total of 300 stroke patients were registered using consecutive sampling. Hyponatremia was defined as serum sodium <135 mEq/L at admission. Clinical outcomes, including hospital stay, GCS, mRS, complications, and mortality, were compared between hyponatremic and normonatremic patients. Multivariate logistic regression identified independent mortality predictors. Results: Hyponatremia was observed in 90 (30%) patients. Hyponatremic patients had significantly longer hospital stays (9.2 ± 3.1 vs. 6.8 ± 2.4 days, p<0.001), lower GCS at admission (10.9 ± 3.0 vs. 12.8 ± 2.6, p<0.001), and altered rates of ICU admission (26.7% vs. 14.3%, p=0.006). They also had increased in-hospital complications, including aspiration pneumonia (22.2% vs. 11.9%, p=0.02) and seizures (15.6% vs. 8.6%, p=0.05). In-hospital mortality was significantly increased in hyponatremic patients (15.6% vs. 5.7%, p=0.005). Hyponatremia independently predicted mortality (OR 2.98, p=0.01). Conclusion: Hyponatremia in stroke patients is associated to prolonged hospitalization, increased ICU admissions, worse neurological outcomes, and higher mortality. Early identification and management of hyponatremia may improve clinical outcomes.