Hemodynamics, fluids & transfusion
Clinical outcomes of early fast compared to slow sodium correction rate in adults with severe hypernatremia: A comparative effectiveness study
Main findingResult — go to the resultAdjusted hazard ratio 0.49 95 % CI 0.28–0.84Authors' conclusion
In this TTE of adults with severe hypernatremia, early fast correction of SNa was associated with lower mortality, greater hospital-free survival, and shorter ICU and hospital stays compared with slow correction.
Study context
- Population
- Critically ill adults with severe hypernatremia (SNa ≥ 155 mmol/L), MIMIC-IV database430 analysed after matching
- Participants
- 1,861 adults
- Exposure
- Early fast vs slow SNa correction within the first 24 h
- Fastn = 233
- Slown = 1,628reference
- Outcome
- Mortality
- Follow-up
- 30 days
Methodological detailsretrospective cohort study, MIMIC-IV database, propensity-score matched, per-protocol analysis
- Retrospective cohort study, MIMIC-IV database
- Propensity-score matched
- Per-protocol analysis
Main finding
As reported in the abstract
Adjusted hazard ratio
0.49
95 % CI 0.28–0.84
P = 0.01
Fast vs Slow
adjusted HR 0.49 (95 % CI 0.28–0.84); P = 0.01
Observational data: associations, not effects.
Secondary outcomes
ICU LOS
P = 0.002
Hospital LOS
P = 0.01
Sensitivity analyses (entropy balancing, inverse probability treatment weighting)
- Sensitivity analyses confirmed robustness of these findings
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Clinical outcomes of early fast compared to slow sodium correction rate in adults with severe hypernatremia: A comparative effectiveness study. J Crit Care. Published 15 November 2025. doi:10.
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