Abstract
This study aims to analyze and organize clinical data and mortality risk for patients with depression who were admitted with hyponatremia, using data from the Cerner Health Facts Database, to provide diagnostic and therapeutic insights for this patient population. This study employed a secondary analysis method to retrospectively analyze and statistically assess cases of hyponatremia upon admission in patients with depression from the Cerner Health Facts Database, which includes over a million hospitalized patients. We statistically analyzed data for 1,048,575 patients, among whom 81,544 (7.78%) had depression. Among these patients, 26,678 cases (32.71%) had hyponatremia ([Na] < 135 mEq/L) upon admission. Significant statistical differences were found between hyponatremic and nonhyponatremic depressed patients in terms of age, race, and Deyo-CCI grouping (all P < .001), although no difference was found in gender (P > .05). Comparisons of comorbidities showed significant differences across 14 indices, including hypertension, myocardial infarction, and coronary artery disease (all P < .05). The mortality rate was 2.65% for depressed patients with hyponatremia and 1.24% for those without, showing a significant difference (P < .001). Logistic regression analysis showed that age, gender, Deyo-CCI score, and comorbidities, including hypertension, myocardial infarction, coronary artery disease, heart failure, adrenal insufficiency, cerebrovascular disease, hemiplegia/paraplegia, malignancy, lung cancer, pneumonia, sepsis, urinary tract infection, and hyponatremia were independent factors influencing mortality risk in depressed patients (all P < .05). The model (Model 1, 16 items) constructed with these factors had an area under the ROC curve (AUC) of 0.816 (z = 57.523, P < .001), with a sensitivity of 80.63%, specificity of 67.54%, and a Youden index of 0.482. To facilitate clinical application, we developed Model 2 (6 items), which indicated a moderate diagnostic performance with an AUC of 0.773. The mortality risk for patients with depression and hyponatremia upon admission is twice as high as that for nonhyponatremic patients. This outcome is influenced by factors such as age, gender, Deyo-CCI score, and various comorbidities. It is essential to analyze the causes of hyponatremia upon admission in depressed patients and take appropriate therapeutic measures accordingly.