Discovering knowledge on pediatric fluid therapy and dysnatremias from quantitative data found in electronic medical records.

It is accepted that intravenous fluid (IVF) therapy can result in hospital-acquired dysnatremias in pediatric patients, with associated morbidity and mortality. There is interest in improving IVF therapy to prevent dysnatremias, but the optimal approach is controversial. In this study, we develop Natremia Deviation and Intravenous Renderer (NaDIR), a tool that preprocesses large volumes of electronic medical record data obtained from an academic pediatric hospital in order to analyze (1) IVF therapy, (2) the epidemiology of dysnatremias, and (3) the impact of IVFs on changes in serum sodium (ΔS(Na)). We then applied NaDIR to 3,256 inpatient records over a 3 month period, which revealed (1) a 19.9% incidence of dysnatremias, (2) a significant increase in lengths of stay associated with dysnatremias, and (3) a novel linear relationship between ΔS(Na) and IVF tonicity. This demonstrates that EMR data that can be readily analyzed to discover epidemiologic and predictive knowledge.