Affiliation:
1. Final year post-graduate, Department of General Medicine, Santhiram Medical College and General Hospital, Nandyal
2. M.D., Assistant Professor, Department of General Medicine, Santhiram Medical College and General Hospital, Nandyal
3. Vijaya Kumar
Abstract
Background: Hyponatremia is a common electrolyte disturbance in the hospitalized elderly sick patient.
Objectives:
1. To study clinical features and etiology of hyponatremia in elderly hospitalized patients.
2. To classify severity of hyponatremia in hospitalized elderly and to correlate with outcome following treatment.
Methods: All elderly patients being admitted to ICU were screened for hyponatremia and 100 elderly hospitalized patients with severe
hyponatremia were included in study, these patients were investigated as per protocol and were treated as per standardized regimen. Results: 100
patients with severe hyponatremia were studied. The common CNS symptoms were drowsiness, lethargy, confusion, seizures and
unresponsiveness. There was female preponderance of cases (55%). The common co-morbid conditions were Hypertension (69) and diabetes
mellitus (51). Females tolerated hyponatremia better than males with mortality of 9.09% in females and 33.33% in males (p=0.0026). In all 20
patients succumbed to their primary illness, with a possible contribution attributable to hyponatremia or its treatment. The common cause of
Hyponatremia was SIADH (30) and drugs (24) of which diuretics is a major chunk. Conclusion: In general hyponatremia is common in females
and they seem to better tolerate it than their male counterparts. Early detection, strict adherence to treatment protocol is required.Diuretics should
be used with caution in elderly.
Subject
General Agricultural and Biological Sciences,Philosophy,Classics,Physical and Theoretical Chemistry,Mechanical Engineering,General Chemical Engineering,Infectious Diseases,Cell Biology,Cellular and Molecular Neuroscience,Biochemistry,Law,Social Sciences (miscellaneous),History,General Economics, Econometrics and Finance,Business and International Management,Mechanical Engineering,Ocean Engineering,Aerospace Engineering,Condensed Matter Physics,Nuclear Energy and Engineering,Civil and Structural Engineering,Statistical and Nonlinear Physics,Statistics and Probability,Industrial and Manufacturing Engineering,Management Science and Operations Research,Statistics, Probability and Uncertainty,Statistics and Probability
Reference9 articles.
1. Ellison DH, Berl T. The syndrome of inappropriate antidiuresis. N Engl J Med 2007; 356:2064.
2. Nzerue Chike M., Baffoe-Bonnie Henry, You Wei, Falana Babajide, and Dai Shifan. Predictors of Outcome in Hospitalized Patients with Severe Hyponatremia. Journal of the National Medical Association Vol. 95, No. 5, May 2003 335-343.
3. Drummond M.Cost-of-illness studies: a major headache? Pharmacoeconomics.1992;2:1–4.
4. Ganong F William, The General and Cellular Basis of Medical Physiology. In Review of Medical Physiology, William F Ganong. 2003 21st edition, 6. McGraw Hill publication.
5. Skorecki Karl, Ausiello Dennis. Disorders of Sodium and Water Homeostasis. In Goldman: Cecil Medicine, Arend William P. , Armitage James O.,Clemmons David R.,Drazen Jeffrey M.,Griggs Robert C.,Larusso Nicholas,Foster Elizabeth,Newman Jane.2008 23rd edirion.chapter 117.WB Saunders Company