Dehydration as referral diagnosis to a medical admittance department.

INTRODUCTION

Patients are frequently admitted to hospital on suspicion of dehydration. The diagnosis is widely used for referral to admittance departments. We aimed to prospectively evaluate patients admitted with a diagnosis of dehydration in terms of the accuracy of this diagnosis, to evaluate clinical and biochemical data and to evaluate the outcome and provide a review of the concept of dehydration.

METHODS

Patients who had dehydration as their primary referral diagnosis were prospectively included over a 70-day period. We defined dehydration based on osmolality > 295 mmol/kg. Biochemistry, imaging and outcome were examined.

RESULTS

A total of 128 patients were admitted on suspicion of dehydration, accounting for 7.5% of all patients admitted. In all, 82 of the 128 (64%) were dehydrated. The diagnoses at discharge included infections mainly, but also diagnoses such as cancers and stroke were registered. Mortality during hospitalisation was 9%. Mortality at six months was 27% for the entire group; 37% in the dehydration group versus 11% in the non-dehydration group (p = 0.002). Older age was the strongest predictor of death.

CONCLUSIONS

Suspicion of dehydration is a frequent admittance diagnosis. We suspect that a referral diagnosis of dehydration often reflects an unspecified concern rather than a real suspicion of dehydration. Patients with dehydration had a high in-hospital and six-month mortality, reflecting the severity of this diagnosis.

FUNDING: not relevant.

TRIAL REGISTRATION: The Danish Data Protection Agency, R. no. 05380, BFH-2017-029.