The authors regret that in preparation of a new article based on the same data as in the previous published article[[1]Falhammar H Calissendorff J Skov J Nathanson D Lindh JD Mannheimer B. Tramadol- and codeine-induced severe hyponatremia: A Swedish population-based case-control study.], we unfortunately discovered two errors in the dataset. Some cases of hyponatremia as a secondary diagnosis had erroneously been included as primary diagnosis of hyponatremia. The corrected number of cases admitted with a primary diagnosis of hyponatremia decreased to 11,213 instead of 14,359 as reported in the article, and as a consequence the number of matched controls decreased to 44,801 instead of 57,382. The second error in the dataset was that the index date, initially labelled as the date of admission by the National Board of Health and Welfare was in fact the discharge date. After correcting for these two errors, results were overall similar, with slight differences as specified below.Tramadol- and codeine-induced hospitalization due to hyponatremia1When re-analyzing newly initiated codeine therapy separated from ongoing treatment, the association for ongoing treatment was statistically significant. In the published article this association was near significant (P=0.07).

The conclusion in the published article was “Associations were found between tramadol or codeine usage and hospitalization due to hyponatremia which were markedly increased in those newly initiated. The risk associated with long-term use was not increased. The association may be causally related to the drugs, although an effect due to pain, nausea or the underlying disease cannot be excluded.”

In the light of the revised analysis, we now conclude:

“Associations were found between tramadol or codeine usage and hospitalization due to hyponatremia which were markedly increased in those newly initiated. The risk associated with long-term use was not increased for tramadol while ongoing use of codeine was associated with a small but significant increase in risk. The association may be causally related to the drugs, although an effect due to pain, nausea or the underlying disease cannot be excluded.”

The authors would like to apologise for any inconvenience caused.

ReferenceFalhammar H Calissendorff J Skov J Nathanson D Lindh JD Mannheimer B.

Tramadol- and codeine-induced severe hyponatremia: A Swedish population-based case-control study.

Eur J Intern Med. 69: 20-24Article InfoPublication History

Published online: June 22, 2021

Accepted: May 15, 2021

Publication stageIn Press Corrected ProofIdentification

DOI: https://doi.org/10.1016/j.ejim.2021.05.043

Copyright

© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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