When we published our study <evidence.nejm.org/doi/10.1056/EV…> of ODS and hyponatremia we were pummeled for including people at low risk of ODS because we included Na levels between 120 and 130. They said it is well known 'that ODS is incredibly rare/non-existent at those levels.' 1/4

Of course one of the reasons it was thought to be incredibly rare was that no one looked for CPM in patients with Na from 120-130. We found a fair number (≤5 of 12). 2/4

Our findings are replicated in a study from Australia. The authors took a different approach to investigating ODS. Instead of starting w/ hyponatremia and working forward to ODS, they started with a dx of ODS and worked backwards
ncbi.nlm.nih.gov/pubmed/35717664 3/4

And take a look at how many of the sodiums were above 120

13 out of 15 cases

Also note that only 2 patients had rapid correction of sodium😳

Malnutrition, hypokalemia, and alcohol continue to represent as they do in every study. 4/4