A Study on Hyponatremia in Critically Ill Geriatric Patients

Abstract

Background: Hyponatremia is a condition when serum sodium is <135 meq/L and is considered severe when <125mEq/l. It can be due to abnormal sodium or water balance and is the most common electrolyte disorder occurring in critically ill patients and particularly so in the elderly. Aims: Present study aims to ascertain etiological factors, frequency and outcome of hyponatremia in critically ill geriatric patients and describe its clinical manifestations. Methods: This observational study was conducted in an intensive care unit of a tertiary care hospital of Rajasthan on 100 geriatric patients over a period of 1 year. Observation: In this study 62 males and 38 females were admitted with hypopnatremia with 25% having mild and 67% moderate hyponatremia; of which 58% were symptomatic having lethargy (34%) and postural dizziness (27%)as the common clinical presentation. Hypertension(57%) and diabetes (43%) were frequent comorbities while CCF (40%) followed by drugs (16%) were the common etiologies. Fluid restriction (63%) was the major treatment followed by diuretics (23%), normal saline (14%) and hypertonic saline (5%) with an overall mortality of 10% unrelated to the severity of hyponatremia at presentation. Conclusion: Hyponatremia is a significant cause of morbidity and mortality in critically ill geriatric patients and needs special consideration to decrease the ICU stay and associated morbidity.

Keywords

• hyponatremia
• geriatrics
• electrolyte disorder
• critical care