Table 3.
Hypernatremia | Normal sodium | ||||||||
---|---|---|---|---|---|---|---|---|---|
Case 1 | Case 2 | Case 3 | Case 4 | Case 5 | Case 6 | Case 7 | Case 8 | ||
Demographics | Age (years) | 79 | 66 | 76 | 77 | 58 | 82 | 64 | 64 |
Sex | M | M | M | M | M | M | M | M | |
Race | White | Asian | Asian | White | White | White | White | White | |
Serum (highest) | White blood cell count (#/ul) | 10.0 | 23.1 | 31.4 | 13.63 | 19.8 | 10.3 | 45.9 | 18.2 |
Hemoglobin (g/dl) | 14.9 | 15.2 | 13.4 | 16.7 | 14 | 11.7 | 14.7 | 12.6 | |
D-dimer (mg/L FEU) | 3.768 | 31.04 | 1.62 | 2.60 | 36.39 | ||||
Alanine aminotransferase (IU/L) | 34 | 54 | 157 | 95 | 164 | 75 | 93 | 36 | |
Aspartate aminotransferase (IU/L) | 99 | 65 | 122 | 91 | 226 | 62 | 91 | 77 | |
Creatinine (mg/dL) | 1.21 | 1.18 | 7.27 | 2.61 | 2.85 | 1.41 | 7.82 | 10.60 | |
Troponin I (ng/mL) | 0.036 | < 0.020 | 0.210 | 0.018 | 0.352 | 0.150 | 1.110 | 0.238 | |
Sodium (mEq/L) | 163 | 152 | 146 | 156 | 150 | 163 | 142 | 145 | |
Hypernatremia severity • Mild (146-150 mEq/L • Moderate (151-154 mEq/L) • Severe (≥ 155 mEq/L) |
Severe | Moderate | Mild | Severe | Mild | Severe | None | None | |
Vitals (admission) | SpO2 (%) | ? | 89 | 93 | 91 | 90 | 92 | 93 | 88 |
Temperature (F) | ? | 98.1 | 100.4 | 97.5 | 98.3 | 97.9 | 102.7 | 101.4 | |
Pulse (beats/min) | ? | 105 | 107 | 71 | 97 | 97 | 146 | 74 | |
Blood pressure (mmHg) | ? | 142/69 | 132/66 | 139/68 | 113/55 | 128/76 | 133/95 | 183/69 | |
Arrival mode to Emergency Department | Walk-in | Ambulance | Ambulance | Walk-in | Walk-in | ||||
Cerebrospinal Fluid (CSF) analysis | White blood cell count (#/ul) | Normal | Normal | Normal | High | Normal | Normal | Normal | High |
Total cell count (#/ul) | Normal | Normal | High | High | Normal | Normal | Normal | High | |
Total protein (mg/dl) | High | High | Normal | High | Normal | Normal | High | High | |
Glucose (mg/dl) | High | Normal | High | High | High | High | High | High | |
IgG | Normal | High | |||||||
Neuron specific enolase (NSE) | High | ||||||||
Lactate dehydrogenase (LDH) | Normal | Normal | |||||||
Clinical outcome | Neurological symptoms | Myoclonus, metabolic encephalopathy, unspecified convulsions, anorexia | Metabolic encephalopathy, encephalitis and encephalomyelitis, unspecified convulsions | Nausea, seizures, encephalopathy | Cerebral infarction, quadriplegia, unspecified, febrile convulsions, dysphagia | Metabolic encephalopathy, absence epileptic syndrome, intractable, with status epilepticus | |||
Other diagnosis | Sepsis, ARDS, hypertension, benign prostate hypertrophy | Sepsis, ARDS, cardiac arrest, acute kidney failure, type 2 DM | Sepsis, ARDS, acute kidney failure, acute liver failure | Sepsis, ARDS, type 2 DM, diabetic neuropathy, nephropathy, acute diastolic heart failure | ARDS, Morbid obese, type 2 DM, HT | ARDS, type 2 DM, HL, cardiac arrest | |||
Disease severity | Severe/critical | Severe/critical | Severe/critical | Severe/critical | Severe/critical | Severe/critical | Severe/critical | Severe/critical | |
Ventilator need | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |
Ventilator time | ? | 28 days | 25 days | 17 days | 27 days | 16 | 11 | 5 | |
Length of stay in hospital | 26 | 41 | 45 | 20 | 39 | 20 | 31 | 17 | |
In-hospital mortality | Ex | Ex | Ex | Ex | Discharged | Ex | Discharged | Ex |