C39-36 Hyponatremia as a Predictor of Adverse Outcomes in Sarcoidosis Patients

Abstract Rationale Hyponatremia, a common electrolyte imbalance, may influence clinical outcomes in patients with sarcoidosis, a systemic inflammatory disease. Previous research has demonstrated hyponatremia as a poor prognostic indicator in several clinical syndromes, most notably heart failure, end stage renal disease, cirrhosis, and pulmonary embolism. This study investigates the association between hyponatremia and mortality, hospital length of stay (LOS), and costs in sarcoidosis patients. This research also identifies trends in sarcoidosis and hyponatremia prevalence from 2016 to 2022. Methods Using a large-scale, survey-weighted dataset from the National Inpatient Sample (2016-2022), we analyzed 112, 409 sarcoidosis hospitalizations. Logistic regression models estimated crude and adjusted odds ratios (ORs) for mortality by hyponatremia status, adjusting for age, sex, race, income, comorbidities (Charlson index), hospital region, bed size, payer, and teaching status. Incidence of hyponatremia and sarcoidosis was assessed over time, and regression analyses evaluated predictors of hyponatremia and comorbidities. Mean LOS and total charges were compared between sarcoidosis patients with and without hyponatremia. Results Hyponatremia was present in 9. 6% of sarcoidosis patients. The crude OR for mortality in sarcoidosis patients with hyponatremia was 2. 08 (95% CI: 1. 89-2. 28), and the adjusted OR was 1. 90 (95% CI: 1. 72-2. 10, p 0. 001). Mortality rates were 5. 12% in sarcoidosis patients with hyponatremia versus 2. 53% without (p 0. 001). Hyponatremia was associated with longer LOS (8. 39 vs. 5. 45 days, p 0. 001) and higher hospital charges (99, 746 vs. 66, 662, p 0. 001). The incidence of hyponatremia among sarcoidosis patients increased from 7. 43% in 2016 to 11. 99% in 2022 (p-trend0. 001), while sarcoidosis prevalence remained stable (0. 23-0. 24%, p-trend=0. 106). Significant predictors of hyponatremia included diabetes mellitus (OR 1. 21, p 0. 001), higher Charlson index (OR 1. 65 for category 3, p 0. 001), and Asian race (OR 1. 40, p 0. 001). Comorbidities like malnutrition (8. 97% vs. 3. 77%) and end-stage renal disease (9. 24% vs. 5. 28%) were more prevalent in sarcoidosis patients with hyponatremia. Conclusion Hyponatremia in sarcoidosis patients predicts increased mortality, longer hospital stays, and higher costs, but our study’s reliance on ICD codes, which do not distinguish sarcoidosis flares from other admissions, suggests it may partly reflect comorbidities like malnutrition or renal disease. However, its independent association with adverse outcomes (aOR 1. 90) indicates prognostic value beyond comorbidities. Future studies should explore mechanisms, such as inflammatory pathways, and assess whether correcting hyponatremia improves outcomes in sarcoidosis patients This abstract is funded by: None