Symptoms and Characteristics of Individuals with Profound Hyponatremia: A Prospective Multicenter Observational Study.
J Am Geriatr Soc. 2015 Mar 4;
Authors: Nigro N, Winzeler B, Suter-Widmer I, Schuetz P, Arici B, Bally M, Blum C, Bingisser R, Bock A, Huber A, Müller B, Nickel CH, Christ-Crain M
Abstract
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.
PMID: 25735607 [PubMed - as supplied by publisher]