{"id":19621,"date":"2024-04-25T14:22:42","date_gmt":"2024-04-25T18:22:42","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=19621"},"modified":"2024-05-06T14:33:44","modified_gmt":"2024-05-06T18:33:44","slug":"hyponatremia-associated-hospital-visits-are-not-reduced-by-early-electrolyte-testing","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/hyponatremia-associated-hospital-visits-are-not-reduced-by-early-electrolyte-testing\/","title":{"rendered":"Hyponatremia-associated hospital visits are not reduced by early electrolyte testing in older adults starting antidepressants"},"content":{"rendered":"

Background<\/strong> — Clinical practice guidelines recommend early serum electrolyte monitoring when starting antidepressants in older adults due to the increased risk of hyponatremia. It is unclear whether this monitoring improves outcomes.<\/p>\n

Methods<\/strong> — Population-based, retrospective cohort study of Ontario adults aged \u226566\u2009years who initiated therapy with a selective serotonin reuptake inhibitor (SSRI) or selective norepinephrine reuptake inhibitor (SNRI) between April 1, 2013, and January 31, 2020. The index date was the date of the first such prescription, and the exposure of interest was serum electrolyte measurement during the subsequent 7\u2009days. The primary outcome was any emergency department or hospital admission with hyponatremia within 8\u201360\u2009days of antidepressant initiation. Poisson regression models compared individuals who had versus did not have their serum electrolytes tested in the week following SSRI\/SNRI initiation, weighting by propensity score-based overlap weights.<\/p>\n

Results<\/strong> — Among the 420,085 patients aged \u226566\u2009years initiating treatment with an SSRI\/SNRI, 26,808 (6.4%) had serum electrolytes measured in the subsequent 7\u2009days and 6109 (1.5%) subsequently presented to hospital with hyponatremia. The time from drug initiation to hospitalization varied (median 29, interquartile range [IQR] 17\u201344\u2009days), and the median sodium concentration measured in the community (136, IQR 133\u2013138\u2009mmol\/L) was marginally higher than those at the time of hospitalization (132, IQR 130\u2013134\u2009mmol\/L). Patients who underwent electrolyte testing in the week following SSRI\/SNRI treatment were more likely to attend an emergency department (ED) or hospital with hyponatremia within 8\u201360\u2009days relative to those who did not (relative risk\u2009=\u20092.31, 95% confidence interval: 2.16\u20132.46).<\/p>\n

Conclusions<\/strong> — Testing serum electrolytes in the week after starting an SSRI\/SNRI is not associated with a reduced risk of a hospital visit with hyponatremia. These findings do not support current guidelines recommending routine electrolyte monitoring.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background — Clinical practice guidelines recommend early serum electrolyte monitoring when starting antidepressants in older adults due to the increased risk of hyponatremia. It is unclear whether this monitoring improves outcomes. Methods — Population-based, retrospective cohort study of Ontario adults aged \u226566\u2009years who initiated therapy with a selective serotonin reuptake inhibitor (SSRI) or selective norepinephrine […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,17,56,31],"migration-helper-qa-sample-set":[],"class_list":["post-19621","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-older-people","topic-pharmacoepidemiology-and-drug-safety","topic-pharmacy"],"acf":{"citation":"Lane NE, Bai L, Seitz DP, Juurlink DN, Paterson JM, Guan J, Stukel TA. J Am Geriatr Soc<\/em>. 2024; Apr 25 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1111\/jgs.18930","ices_scientist":[1356,1282,1100,1372],"site":[6733],"research_program":[6747],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | Hyponatremia-associated hospital visits are not reduced by early electrolyte testing in older adults starting antidepressants<\/title>\n<meta name=\"description\" content=\"Background — Clinical practice guidelines recommend early serum electrolyte monitoring when starting antidepressants in older adults due to the Clinical practice guidelines recommend early serum electrolyte monitoring when starting antidepressants in older adults due to the increased\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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