{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T14:51:00Z","timestamp":1773845460319,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Hyponatremia is shown to prolong hospitalization and increase mortality. The role of hyponatremia in chronic obstructive pulmonary disease is widely studied with a focus on hospitalized patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate whether hyponatremia increases the probability of re\u2010exacerbations in non\u2010hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with AECOPD who required an emergency department (ED) visit and who were discharged home were included in this single\u2010center, retrospective study. Demographics and laboratory values were compared between patients with hyponatremia (&lt;135 mmol\/L) and normonatremia (135\u2010145 mmol\/L). The predictors of the patients\u2019 ED revisit in the course of one year were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of all the 3274 patients, baseline sodium values were classified as hyponatremia in 720 (22%). Hyponatremia was most frequently present as mild (85%). Patients with hyponatremia had higher Charlson comorbidity scores, higher leucocytes, lower hemoglobin, lower platelet, higher neutrophil to lymphocyte ratios, lower eosinophilia, higher aspartate aminotransferase and C\u2010reactive protein values (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, for all), and higher frequency of 1\u2010month revisit (36.7% vs. 31.5%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009). Independent predictors of revisits within 1 year after the index visit were detected as long\u2010term oxygen treatment requirement (HR: 0.768 CI: 0.695\u20100.848, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001), higher urea levels (HR: 0.997 CI: 0.995\u20100.999, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003), and baseline hyponatremia (HR: 0.786 CI: 0.707\u20100.873, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Revisit interval was median 78\u00a0\u00b1\u00a03.4 days in patients with normonatremia and 51\u00a0\u00b1\u00a04.8 days in hyponatremia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In non\u2010hospitalized AECOPD, hyponatremia is relatively frequent and correlates with inflammatory markers. The presence of hyponatremia is an independent predictor of an earlier ED return visit within 1 year. For patients with AECOPD, sodium values may present guidance on discharge versus longer observation decisions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13409","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T17:45:38Z","timestamp":1623087938000},"page":"1063-1072","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hyponatremia is an independent predictor of emergency department revisits in acute exacerbation of COPD"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3793-9834","authenticated-orcid":false,"given":"Fatma","family":"Tokg\u00f6z Aky\u0131l","sequence":"first","affiliation":[{"name":"Department of Chest Diseases Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0657-0392","authenticated-orcid":false,"given":"Seda","family":"Tural \u00d6n\u00fcr","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4041-7479","authenticated-orcid":false,"given":"H\u00fclya","family":"Abal\u0131","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7184-2075","authenticated-orcid":false,"given":"Sinem","family":"S\u00f6k\u00fcc\u00fc","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9816-8885","authenticated-orcid":false,"given":"Cengiz","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5917-2574","authenticated-orcid":false,"given":"Neslihan","family":"Boyrac\u0131","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7368-2714","authenticated-orcid":false,"given":"Asl\u0131","family":"Kocao\u011flu","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7521-8651","authenticated-orcid":false,"given":"Sedat","family":"Alt\u0131n","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2012.713880"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40248-018-0149-0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S52557"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa0803563"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000088092"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0150737"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2016.03.007"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080451"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2012.06.037"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2016.07.028"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.513"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2016.05.003"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9020503"},{"key":"e_1_2_10_15_1","first-page":"335","article-title":"Derivation of a prognostic equation to predict in\u2010hospital mortality and requirement of invasive mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease","volume":"50","author":"Mohan A","year":"2008","journal-title":"Indian J Chest Dis Allied Sci"},{"issue":"4","key":"e_1_2_10_16_1","article-title":"Clinical factors, including all patient refined diagnosis related group severity, as predictors of early rehospitalization after COPD exacerbation","volume":"18","author":"Roberts MH","year":"2015","journal-title":"Drugs Context"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0161232"},{"key":"e_1_2_10_18_1","volume-title":"Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2018 Report"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)00055-8"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197310182891607"},{"key":"e_1_2_10_22_1","volume-title":"COPD: Who Cares When it Matters Most? National Chronic Obstructive Pulmonary Disease (COPD) Audit Programme: Outcomes from the Clinical Audit of COPD Exacerbations Admitted to Acute Units in England 2014. National Supplementary Report","author":"Stone RA","year":"2017"},{"issue":"2","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1513\/AnnalsATS.201507-439OC","article-title":"Depression is associated with readmission for acute exacerbation of chronic obstructive pulmonary disease","volume":"13","author":"Iyer AS","year":"2016","journal-title":"Ann Am Thorac Soc"},{"key":"e_1_2_10_24_1","unstructured":"Available at:https:\/\/dosyamerkez.saglik.gov.tr\/Eklenti\/23496 2017\u2010ocak\u2010ekim\u2010donemi\u2010acil\u2010servis\u2010verileri2pdf.pdf?0. Accessed December 1 2020."},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3329\/fmcj.v15i1.49006"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00284202"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2015.1067294"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-14-127"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-018-0951-4"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S139470"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12471"},{"issue":"57","key":"e_1_2_10_32_1","first-page":"3303","article-title":"Predictors of readmission after hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD)","volume":"42","author":"Sprooten RTM","year":"2013","journal-title":"Eur Resp J."},{"issue":"71","key":"e_1_2_10_33_1","first-page":"e1","article-title":"Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits","volume":"119","author":"Renneboog B","year":"2006","journal-title":"Am J Med"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00041.2006"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/10253890410001733535"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2005.060038"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0124105"}],"container-title":["The Clinical Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/crj.13409","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/crj.13409","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/crj.13409","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T06:13:25Z","timestamp":1693289605000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/crj.13409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,21]]},"references-count":36,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1111\/crj.13409"],"URL":"https:\/\/doi.org\/10.1111\/crj.13409","archive":["Portico"],"relation":{},"ISSN":["1752-6981","1752-699X"],"issn-type":[{"value":"1752-6981","type":"print"},{"value":"1752-699X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,21]]},"assertion":[{"value":"2021-01-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}