Journal of the American Geriatrics Society · 2015
Symptoms and characteristics of individuals with profound hyponatremia: a prospective multicenter observational study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Nigro Nicole, Winzeler Bettina, Suter-Widmer Isabelle, Schuetz Philipp, Arici Birsen, Bally Martina, Blum Claudine, Bingisser Roland, Bock Andreas, Huber Andreas, Müller Beat, Nickel Christian H, Christ-Crain Mirjam
Аннотация
OBJECTIVES: To assess symptoms and characteristics of hyponatremia, the most common electrolyte disturbance in hospitalized individuals and a condition that is associated with substantial morbidity and mortality.
DESIGN: Prospective observational multicenter study.
SETTING: Two Swiss academic centers.
PARTICIPANTS: Individuals with profound hypoosmolar hyponatremia (sodium<125 mmol/L) (N=298).
MEASUREMENTS: All symptoms and complete medical history including current medications, therapy management, and in-hospital outcomes were recorded.
RESULTS: The median age of all participants was 71 (interquartile range (IQR) 60-80), 195 (65%) were female, and mean serum sodium value on admission was 120 mmol/L (IQR 116-123 mmol/L). Frequent clinical symptoms were nausea (n=130, 44%), acute vomiting (n=91, 30%), generalized weakness (n=205, 69%), fatigue (n=175, 59%), gait disturbance (n=92, 31%), recurrent falls (n=47, 16%), and acute falls (n=60, 20%). Fractures were reported in 11 participants (4%). More-severe symptoms such as acute epileptic seizures and focal neurological deficits were identified in 16 (5%) and 17 (5%) participants, respectively. The most common comorbidities were hypertension (n=199, 67%), congestive heart failure (n=44, 15%), chronic renal failure (n=64, 21%), pulmonary disease (82, 28%), and central nervous system disease (n=114, 38%). During hospitalization, 12 (4%) participants died, and 103 (35%) needed treatment in the intensive care unit.
CONCLUSION: A wide spectrum of symptoms accompanies profound hyponatremia. Most participants had moderate symptoms mirroring chronic hyponatremia with brain cell adaptation. Participants with profound hyponatremia had several comorbidities.
DESIGN: Prospective observational multicenter study.
SETTING: Two Swiss academic centers.
PARTICIPANTS: Individuals with profound hypoosmolar hyponatremia (sodium<125 mmol/L) (N=298).
MEASUREMENTS: All symptoms and complete medical history including current medications, therapy management, and in-hospital outcomes were recorded.
RESULTS: The median age of all participants was 71 (interquartile range (IQR) 60-80), 195 (65%) were female, and mean serum sodium value on admission was 120 mmol/L (IQR 116-123 mmol/L). Frequent clinical symptoms were nausea (n=130, 44%), acute vomiting (n=91, 30%), generalized weakness (n=205, 69%), fatigue (n=175, 59%), gait disturbance (n=92, 31%), recurrent falls (n=47, 16%), and acute falls (n=60, 20%). Fractures were reported in 11 participants (4%). More-severe symptoms such as acute epileptic seizures and focal neurological deficits were identified in 16 (5%) and 17 (5%) participants, respectively. The most common comorbidities were hypertension (n=199, 67%), congestive heart failure (n=44, 15%), chronic renal failure (n=64, 21%), pulmonary disease (82, 28%), and central nervous system disease (n=114, 38%). During hospitalization, 12 (4%) participants died, and 103 (35%) needed treatment in the intensive care unit.
CONCLUSION: A wide spectrum of symptoms accompanies profound hyponatremia. Most participants had moderate symptoms mirroring chronic hyponatremia with brain cell adaptation. Participants with profound hyponatremia had several comorbidities.