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Symptoms and Characteristics of Individuals with Profound Hyponatremia: A Prospective Multicenter Observational Study
Author(s) -
Nigro Nicole,
Winzeler Bettina,
SuterWidmer Isabelle,
Schuetz Philipp,
Arici Birsen,
Bally Martina,
Blum Claudine,
Bingisser Roland,
Bock Andreas,
Huber Andreas,
Müller Beat,
Nickel Christian H.,
ChristCrain Mirjam
Publication year - 2015
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13325
Subject(s) - medicine , hyponatremia , interquartile range , nausea , heart failure , observational study , vomiting , pediatrics , prospective cohort study
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.