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dc.contributor.authorCohen, Jeremy-
dc.contributor.authorDelaney, Anthony-
dc.contributor.authorAnstey, James-
dc.contributor.authorAnstey, Matthew-
dc.contributor.authorBarge, Deborah-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorBhardwa, Vishnu-
dc.contributor.authorBrinkerhoff, Gail-
dc.contributor.authorBoard, Jasmin-
dc.contributor.authorCampain, Anna-
dc.contributor.authorCooper, D James-
dc.contributor.authorDi Tanna, Gian Luca-
dc.contributor.authorFinnis, Mark-
dc.contributor.authorFitzgerald, Emily-
dc.contributor.authorFlower, Oliver-
dc.contributor.authorHealey, Paul-
dc.contributor.authorHunt, Anna-
dc.contributor.authorLawrence, Cassie-
dc.contributor.authorMerthens, Jan-
dc.contributor.authorNewby, Lynette-
dc.contributor.authorPearson, David-
dc.contributor.authorRaith, Eamon-
dc.contributor.authorRobertson, Yvonne-
dc.contributor.authorSchweikert, Sacha-
dc.contributor.authorStarr, Therese-
dc.contributor.authorTallott, Mandy-
dc.contributor.authorvan der Poll, Andrew-
dc.contributor.authorYoung, Paul-
dc.contributor.authorUdy, Andrew-
dc.identifier.citationCritical Care Explorations 2021; 3(6): e0445en
dc.description.abstractTo investigate the association between plasma sodium concentrations and 6-month neurologic outcome in critically ill patients with aneurysmal subarachnoid hemorrhage. Prospective cohort study. Eleven ICUs in Australia and New Zealand. Three-hundred fifty-six aneurysmal subarachnoid hemorrhage patients admitted to ICU between March 2016 and June 2018. The exposure variable was daily measured plasma sodium. None. Six-month neurologic outcome as measured by the modified Rankin Scale. A poor outcome was defined as a modified Rankin Scale greater than or equal to 4. The mean age was 57 years (± 12.6 yr), 68% were female, and 32% (n = 113) had a poor outcome. In multivariable analysis, including age, illness severity, and process of care measures as covariates, higher mean sodium concentrations (odds ratio, 1.17; 95% CI, 1.05-1.29), and greater overall variability-as measured by the sd (odds ratio, 1.53; 95% CI, 1.17-1.99)-were associated with a greater likelihood of a poor outcome. Multivariable generalized additive modeling demonstrated, specifically, that a high initial sodium concentration, followed by a gradual decline from day 3 onwards, was also associated with a poor outcome. Finally, greater variability in sodium concentrations was associated with a longer ICU and hospital length of stay: mean ICU length of stay ratio (1.13; 95% CI, 1.07-1.20) and mean hospital length of stay ratio (1.08; 95% CI, 1.01-1.15). In critically ill aneurysmal subarachnoid hemorrhage patients, higher mean sodium concentrations and greater variability were associated with worse neurologic outcomes at 6 months, despite adjustment for known confounders. Interventional studies would be required to demonstrate a causal relationship.en
dc.subjectaneurysmal subarachnoid hemorrhageen
dc.subjectcritical careen
dc.titleDysnatremia and 6-Month Functional Outcomes in Critically Ill Patients With Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study.en
dc.typeJournal Articleen
dc.identifier.journaltitleCritical Care Explorationsen
dc.identifier.affiliationDepartment of Neurocritical Care Medicine, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdomen
dc.identifier.affiliationAuckland City Hospital, Auckland, New Zealanden
dc.identifier.affiliationMedical Research Institute of New Zealand and Intensive Care Unit, Wellington, Hospital, Wellington, New Zealanden
dc.identifier.affiliationRoyal Melbourne Hospital, Melbourne, VIC, Australiaen
dc.identifier.affiliationDiscipline of Acute Care Medicine, Department of Surgical Specialties, The University of Adelaide, Adelaide, SA, Australiaen
dc.identifier.affiliationThe George Institute for Global Health, University of New South Wales, Sydney, NSW, Australiaen
dc.identifier.affiliationRoyal North Shore Hospital, Sydney, NSW, Australiaen
dc.identifier.affiliationNorthern Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australiaen
dc.identifier.affiliationSir Charles Gairdner Hospital, Perth, WA, Australiaen
dc.identifier.affiliationAustin Healthen
dc.identifier.affiliationHunter New England Health, Wallsend, NSW, Australiaen
dc.identifier.affiliationThe Alfred Hospital, Melbourne, VIC, Australiaen
dc.identifier.affiliationRoyal Adelaide Hospital, Adelaide, SA, Australiaen
dc.identifier.affiliationGold Coast University Hospital, Gold Coast, QLD, Australiaen
dc.identifier.affiliationRoyal Perth Hospital, Perth, WA, Australiaen
dc.identifier.affiliationRoyal Brisbane and Women's Hospital, Brisbane, QLD, Australiaen
dc.identifier.affiliationThe Wesley Hospital, Brisbane, QLD, Australiaen
dc.identifier.affiliationThe University of Queensland, Brisbane, QLD, Australiaen
dc.identifier.affiliationWellington Hospital, Wellington, New Zealanden
dc.identifier.affiliationChristchurch Hospital, Christchurch, New Zealanden
dc.identifier.pubmedid34124687, Rinaldo
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.openairecristype Care- Analytics Research and Evaluation (DARE) Centre-
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