Abstract
We report a retrospective study of hypernatraemia (serum sodium concentration greater than 150 mmol/l) in an adult in-patient population of a health district during one year. The incidence was 0.3% with at least 60% of cases developing after hospital admission, mainly in elderly patients. Dehydration appeared to be the major cause, with the use of diuretics, depressed conscious level or febrile illness implicated in a majority. Most patients had more than one contributory factor and iatrogenic causes were common. Associated illnesses were often severe and the in-hospital mortality was high (54%) regardless of age. Hypernatraemia in hospitalized patients should be largely avoidable and there is a need for greater awareness of the importance of active maintenance of hydration in susceptible patients.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Beck L. H., Lavizzo-Mourey R. Geriatric hypernatremia [corrected]. Ann Intern Med. 1987 Nov;107(5):768–769. doi: 10.7326/0003-4819-107-5-768. [DOI] [PubMed] [Google Scholar]
- Bhatnagar D., Weinkove C. Serious hypernatraemia in a hospital population. Postgrad Med J. 1988 Jun;64(752):441–443. doi: 10.1136/pgmj.64.752.441. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Himmelstein D. U., Jones A. A., Woolhandler S. Hypernatremic dehydration in nursing home patients: an indicator of neglect. J Am Geriatr Soc. 1983 Aug;31(8):466–471. doi: 10.1111/j.1532-5415.1983.tb05118.x. [DOI] [PubMed] [Google Scholar]
- Leaf A. Dehydration in elderly. N Engl J Med. 1984 Sep 20;311(12):791–792. doi: 10.1056/NEJM198409203111209. [DOI] [PubMed] [Google Scholar]
- Macdonald N. J., McConnell K. N., Stephen M. R., Dunnigan M. G. Hypernatraemic dehydration in patients in a large hospital for the mentally handicapped. BMJ. 1989 Dec 9;299(6713):1426–1429. doi: 10.1136/bmj.299.6713.1426. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ross E. J., Christie S. B. Hypernatremia. Medicine (Baltimore) 1969 Nov;48(6):441–473. doi: 10.1097/00005792-196948060-00002. [DOI] [PubMed] [Google Scholar]
- Sadat A., Paulman P. M., Mathews M. Hypernatremia in the elderly. Am Fam Physician. 1989 Jul;40(1):125–128. [PubMed] [Google Scholar]
- Snyder N. A., Feigal D. W., Arieff A. I. Hypernatremia in elderly patients. A heterogeneous, morbid, and iatrogenic entity. Ann Intern Med. 1987 Sep;107(3):309–319. doi: 10.7326/0003-4819-107-2-309. [DOI] [PubMed] [Google Scholar]