Validation of a Hyponatremia Screening Tool (ABCDF-S score) for Patients with Hypertension Using Thiazide Diuretic Agents in Phrae Province

Abstract

Backgroud: High blood pressure is a common chronic disease with increasing tendency. In treatment, thiazide drugs are used as monotherapy or in combination with other drugs. The most common adverse reactions are hyponatremia, which can lead to illness and death. The hyponatremia screening tool (ABCDF-S score) requires validation to expand its general use.

Objectives: To study the associations and risk factors associated with hyponatremia in hypertensive patients using thiazide diuretics and to verify the validity of the hyponatremia screening tool.

Methods: A retrospective cohort study, descriptive statistics were used to test the hypothesis: Chi-square, odds ratio to calculate risk factor association, and receiver operator characteristic (ROC) curve to assess the overall efficiency of the instrument to predict hyponatremia. Data of hypertensive patients using thiazide diuretics were collected from a patient database from a hospital in a province. For the period from 1 October 2016 to 30 September 2019

Results: An analysis of risk factors associated with hyponatremia and screening scores based on the ABCDF-S score were evaluated in the high-risk group (score > 8) demonstrating sensitivity, specificity and accuracy: 88.81%, 84.13 and 86.62, respectively. In the low-risk group (score < 6) sensitivity, specificity and accuracy were shown to be 84.13%, 88.81% and 86.62, respectively, which were within the statistical criteria. Cut-off scoring to predict high- and low-risk groups confirmed according to AuROC data 98.06%

Conclusion: The ABCDF-S score tool can be used to predict hyponatremia with good accuracy when tested in all patients. Clinical pharmacists and physicians can easily assess the risk of hyponatremia. This tool should be considered at the beginning of prescribing thiazide diuretics for maximum benefit.