Hyponatremia at autopsy: cause of death or simply a marker of severity of the underlying disease
Moldoveanu, S.; Dorubeţ, D.; Astărăstoae, V.; Butnaru, E.
Revista Medico-Chirurgicala a Societatii de Medici Si Naturalisti Din Iasi 117(4): 1028-1034
2013
ISSN/ISBN: 0048-7848 PMID: 24502086 Document Number: 669759
To analyze the possible interpretations of hyponatremia detected at autopsy in vitreous humor in relation to the cause of death and/or associated pathology (cause of death or a simple marker of the severity of associated diseases). Hyponatremia is the most common electrolytic disorder in hospital practice, considered as a risk factor for hospital mortality. We conducted a 3-year forensic casework analysis in view ofestablishing the relationship of hyponatremia with mortality: hyponatremia as a direct cause of death or hyponatremia caused by the severity of the underlying disease which is the cause of death. The forensic cases are not fully reliable. Although the target question has not been answered, our findings plead for the association of hyponatremia with severe diseases (sick cell syndrome) and not for hyponatremia as a cause of death, but this does not seems to be proven either, the percentage of cases with significant hyponatremia increasing from zero in cases of trauma and sudden violent death to 50% in cases of severe chronic diseases. The values obtained by us are in agreement with the data in the literature. Our findings plead for the scenario hyponatremia as a marker of the severity of the underlying disease.