Hyponatremia and Central Pontine Myelinolysis

What is hyponatremia? Information regarding CPM and EPM.

Archive for the tag “HCUPnet”

Hyponatremia Recent Stats:

I have meant to do this for awhile, and I apologize for it taking so long. I guess, better late than never.

The HCUP website reformulated the way that they record statistics. Now, I did not read why or how, but it did show that the previous stats that they recorded before July of 2014 were across the board higher, than what they are listing now. For 2011, I will include all the data points that I found, ie old and newer stats.

Hyponatremia diagnosis codes: ICD-9: 276.1

ICD-10: E87.1

To obtain the date, I used the ICD-9 code: 276.1

For 2011, hyponatremia was recorded as this:

2011 National statistics – principal diagnosis only (hyponatremia only -from all hospitals in US)

Outcomes by 276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 100,215 2,333
In-hospital deaths 1,085 (1.08%) 73 (0.07%)

Therefore, there were a total number of patients that had hyponatremia specifically, 101,300 +/- 2406

If you look at all possible combination of hospitalized patients that had hyponatremia AND an additional condition (ie severe burns, cancer, liver transplant, etc):

2011 National statistics – all-listed
You have chosen all-listed diagnoses. The only possible measure for all-listed diagnoses is the number of discharges who received the diagnoses you selected. If you want to see statistics on length of stay or charges, go back and select “principal diagnosis.”

276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 1,940,211 51,938

Now, these are the NEW reference points, the older version listed for 2011 hyponatremia only diagnosis: 104,744 (discharged), 1,124 people died.

If you include all possible diagnoses with hyponatremia, it is 2, 019, 550 +/- 53,454.

Yeah, that’s a lot of people who are at risk for CPM/EPM if hyponatremia is not diagnosed and managed correctly.

For 2012:

2012 National statistics – principal diagnosis only

Outcomes by 276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 101,330 1,139
In-hospital deaths 1,160 (1.14%) 75 (0.07%)

There is no older version of documenting with this system.

However, if you look at all hospitalizations that included hyposmolality:

2012 National statistics – all-listed
You have chosen all-listed diagnoses. The only possible measure for all-listed diagnoses is the number of discharges who received the diagnoses you selected. If you want to see statistics on length of stay or charges, go back and select “principal diagnosis.”

276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 1,934,996 22,563

I love numbers because they don’t lie. What I don’t like with this 2nd break down (all hospitalization that listed 276.1 with another condition), it is impossible to tell if hyponatremia actually killed the person or the other illness.

Regardless, there an extremely HIGH number of people who are diagnosed with hyponatremia each year, even if it is or isn’t with a secondary diagnosis. More people should be aware of the condition, and how it should be treated! Hopefully, you will spread the word on how common it is to get it, and how it should be treated.

Blessings!

(Use the link below to find the statistics above: http://hcupnet.ahrq.gov/HCUPnet.jsp)

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Hyponatremia: Statistics Updated:

Well, folks, I hate to say that I was right, but I was right. The number of hospitalizations due to hyponatremia increased in 2010. It is an ongoing epidemic, and one that needs to be addressed.

I’m am praying that if you read this post, you will do your part in spreading the word about hyponatremia. PLEASE, share my blog with your friends, family, neighbors, co-workers, ANYONE and EVERYONE that you know. It’s preventable, and it should be a household name.

The following information was obtained from, HCUPnet: http://hcupnet.ahrq.gov/HCUPnet.jsp

2010 National statistics – all-listed
You have chosen all-listed diagnoses. The only possible measure for all-listed diagnoses is the number of discharges who received the diagnoses you selected. If you want to see statistics on length of stay or charges, go back and select “principal diagnosis.”
276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 1,901,923 48,831

Weighted national estimates from HCUP Nationwide Inpatient Sample (NIS), 2010, Agency for Healthcare Research and Quality (AHRQ), based on data collected by individual States and provided to AHRQ by the States. Total number of weighted discharges in the U.S. based on HCUP NIS = 39,008,298. Statistics based on estimates with a relative standard error (standard error / weighted estimate) greater than 0.30 or with standard error = 0 in the nationwide statistics (NIS, NEDS, and KID) are not reliable. These statistics are suppressed and are designated with an asterisk (*). The estimates of standard errors in HCUPnet were calculated using SUDAAN software. These estimates may differ slightly if other software packages are used to calculate variances.

This is a table of the people above that are impacted by age:

Patient and hospital characteristics for
ICD-9-CM all-listed diagnosis code
276.1 Hyposmolality

Total number of discharges Standard errors
Total number of discharges
All discharges 1,901,923 (100.00%) 48,831
Age group <1 25,749 (1.35%) 2,251
1-17 25,657 (1.35%) 2,808
18-44 199,628 (10.50%) 7,021
45-64 586,155 (30.82%) 16,448
65-84 777,902 (40.90%) 21,587
85+ 286,523 (15.06%) 8,866
Missing * *

SO, the majority of those who are being treated for hyponatremia are the elderly. This information tends to be true for the majority of illness and disease. The elderly and children tend to be the targets for most health concerns. However, surprisingly, after the elderly between the ages of 65 and older, the next largest group are adults age 45 to 64. So, children are less likely to develop this than other age groups. I thought that was pretty interesting.

The following section of information includes additional statistics, which I found also surprising. Usually, illnesses or disease tends to target those impoverished, but that is not the case for hyponatremia. Women develop it more than men. Please take your time to read the following statistics, and feel free to ask me questions if you need assistance deciphering the figures.

Patient and hospital characteristics for
ICD-9-CM all-listed diagnosis code
276.1 Hyposmolality
Total number of discharges Standard errors
Total number of discharges
All discharges 1,901,923 (100.00%) 48,831
Sex Male 863,661 (45.41%) 22,666
Female 1,038,073 (54.58%) 26,924
Missing * *
Median income for zipcode Low 525,033 (27.61%) 21,741
Not low 1,330,533 (69.96%) 42,237
Missing 46,357 (2.44%) 4,125
Patient residence Large central metro 511,650 (26.90%) 38,083
Large fringe metro (suburbs) 460,735 (24.22%) 35,726
Medium and small metro 534,770 (28.12%) 39,687
Micropolitan and noncore (rural) 357,490 (18.80%) 18,234
Missing 37,278 (1.96%) 9,566

Weighted national estimates from HCUP Nationwide Inpatient Sample (NIS), 2010, Agency for Healthcare Research and Quality (AHRQ), based on data collected by individual States and provided to AHRQ by the States. Total number of weighted discharges in the U.S. based on HCUP NIS = 39,008,298. Statistics based on estimates with a relative standard error (standard error / weighted estimate) greater than 0.30 or with standard error = 0 in the nationwide statistics (NIS, NEDS, and KID) are not reliable. These statistics are suppressed and are designated with an asterisk (*). The estimates of standard errors in HCUPnet were calculated using SUDAAN software. These estimates may differ slightly if other software packages are used to calculate variances.

If you want to test whether apparent differences are significant, use the Z-Test Calculator. A p-value of less than 0.05 is generally considered statistically significant.

Here is the statistics for those who developed hyponatremia in 2009:

2009 National statistics – all-listed
You have chosen all-listed diagnoses. The only possible measure for all-listed diagnoses is the number of discharges who received the diagnoses you selected. If you want to see statistics on length of stay or charges, go back and select “principal diagnosis.”
276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 1,735,847 52,458

Weighted national estimates from HCUP Nationwide Inpatient Sample (NIS), 2009, Agency for Healthcare Research and Quality (AHRQ), based on data collected by individual States and provided to AHRQ by the States. Total number of weighted discharges in the U.S. based on HCUP NIS = 39,434,956. Statistics based on estimates with a relative standard error (standard error / weighted estimate) greater than 0.30 or with standard error = 0 in the nationwide statistics (NIS, NEDS, and KID) are not reliable. These statistics are suppressed and are designated with an asterisk (*). The estimates of standard errors in HCUPnet were calculated using SUDAAN software. These estimates may differ slightly if other software packages are used to calculate variances.

NOW, I HAVE TO SAY THIS: I NOTICED THAT THERE WAS A DISCREPANCY, A SIGNIFICANT DISCREPANCY, IN THOSE LISTED AS TO HAVE HYPONATREMIA IN 2009, AS THE ONLY DIAGNOSIS IN 2009 VS THE DATA LISTED IN 2010. WHEN I SELECTED HYPOSMOLALITY AS THE ONLY DIAGNOSIS CODE IN 2009, THE STATISTICS DROPPED TO ~90,000 PEOPLE. HOWEVER, WHEN I SELECTED HYPOSMOLALITY AS BEING A DIAGNOSIS WITH OTHER MEDICAL CONDITIONS, THERE WERE OVER 1.7 MILLION. WHEN I FUNNELED THE SAME SEARCH OPTIONS INTO THE 2010 DATA, THE NUMBER WAS THE SAME FOR BOTH SEARCHES.

WHAT DOES THIS MEAN?

I think the information was coded incorrectly in previous years, or in 2010, but it’s difficult to say which information is correct. It is accurate to say that there are millions being treated for hyponatremia each year, but it is apparently difficult to determine if they are developing hyponatremia while being treated in the hospital for other conditions or whether or not they are being hospitalized because they have hyponatremia on its own.

I hope that makes sense, but it’s important to keep that in mind when reviewing the statistics.

I hope to obtain the same information for CPM/EPM, but it’s more difficult because it is rare, and I don’t believe there is an actual single diagnosis code for it. In other words, they include CPM/EPM, in a blanket diagnosis code for central nervous system injury, which can include numerous other injuries.

Well, there you go folks. I am completely exhausted, so I am going to leave it there right now. Please, if you read my blog, and feel that I dropped the ball on a topic or think there should be expansion on a topic, PLEASE, PLEASE, let me know. I do not remember the things I’ve posted about before, and it’s difficult for me to go back and read through my other posts, so I am relying on you to keep me on track.

Thank you!

 

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