Hyponatremia in Elderly In-PatientsCorrespondence Address :
Dr. Subhash Chandra Dash,
H. No. 12, Plot-1635, Lotus Enclave, Lane-3, B. M. Nagar, Opposite to Gandamunda Khandagiri,
Bhubaneswar-751030, Odisha, India.
E-mail: drsubhashdash73@ gmail.com
Introduction: Hyponatremia, the most common dyselectrolytemia, frequently occurs in elderly patients. Multiple aetiologies, association of comorbids play a major role in hyponatremia of elderly patients. Prolonged hospital stay and increased mortality are the consequences.
Aim: To study the prevalence, common aetiologies, comorbids and clinical outcomes of hyponatremia in elderly in-patients.
Materials and Methods: A prospective, observational study was conducted in a teaching hospital on 950 adults =60 years of age, admitted to the Post-graduate Department of Medicine, over a period of 12 months. Detailed history, clinical examination, outcomes, laboratory investigations, imaging studies, diagnoses and causes were recorded. For statistical analyses, histogram, Kolmogrove test for normality test and then Independent t-test, Wilcoxon rank sum test, Pearson’s chi-square test, Fisher’s-exact tests were used.
Results: After excluding 32 patients of pseudo and hyper-natremia, 440 patients (47.9%) had hyponatremia (s. Na+ level of <135 mEq/L) and 478 patients (52.0%) had normal sodium (135-145 mEq/L). The mean age of hyponatremic patients was 69.87±7.94 and 70±8.18 in normonatremic patients (p=0.815). The mean Na+ level was 122.08±8.68 mEq/L in hyponatremic patients and 138.05±2.71 in normonatremic patients. Hypovolemic hyponatremia was most frequent (42.0%). The leading aetiologies were diuretics (28.8%), acute renal failure (27.9%), and severe sepsis (15.2%) but 61.8% of patients with hyponatremia had multiple factors. Hypertension was the most common comorbid (63%) and presence of multiple comorbid was significantly associated with hyponatremia (p<0.001). Hyponatremic group, though hospitalised for longer period (p<0.001), higher mortality rate could not be established (p=0.699); not also with the severity of hyponatremia (p=0.06).
Conclusion: Elderly patients are highly predisposed to hyponatremia and are often dehydrated. Presence of multiple comorbid is a risk factor. Hyponatremia prolongs the hospital stay but severity of underlying illnesses may rather accelerate the mortality rate.
Comorbid, Dehydration, Elderly, Sodium
Subhash Chandra Dash, Naba Kishore Sundaray, Beeravelli Rajesh, Trupti Pagad. HYPONATREMIA IN ELDERLY IN-PATIENTS. Journal of Clinical and Diagnostic Research [serial online] 2019 February [cited: 2019 Mar 26 ]; 13:OC01-OC04. Available from
Date of Submission: Oct 15, 2018
Date of Peer Review: Nov 15, 2018
Date of Acceptance: Dec 05, 2018
Date of Publishing: Feb 01, 2019
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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