ECE2014 Poster Presentations Neuroendocrinology (27 abstracts)
Clinical symptoms and characteristics of hospitalized patients with severe hyponatremia
Nicole Nigro 1 , Bettina Winzeler 1 , Isabelle Suter-Widmer 1 , Philipp Schuetz 2 , Birsen Arici 1 , Martina Bally 2 , Claudine Blum 2 , Christian Nickel 3 , Roland Bingisser 3 , Bock Andreas 4 , Huber Andreas 5 , Beat Müller 2 & Mirjam Christ-Crain 1
1Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland– 2Department of Medical University Clinic and Divison of Endocrinology, Diabetology and Metabolism, Kantonsspital Aarau, Aarau, Switzerland, 3Department of Internal Medicine, University Hospital Basel, Basel, Switzerland, 4Department of Nephrology, Dialysis and Transplantation, Kantonsspital Aarau, Aarau, Switzerland, 5Central Laboratory, Kantonsspital Aarau, Aarau, Switzerland.
Background: Hyponatremia is the most common electrolyte disturbance in hospitalized patients and associated with a substantial morbidity and mortality. Symptoms of severe hyponatremia vary among patients between nonspecific symptoms such as nausea or malaise or acute life threatening brain oedema. Prospective studies to assess symptoms and mortality in patients with severe hyponatremia are lacking.
Methods: In this prospective multicentre observational study 298 patients admitted to the emergency department with severe hypoosmolar hyponatremia (Na<125 mmol/l) were included. All symptoms, complete medical history including current medication, therapy management and in-hospital mortality were recorded.
Results: Median age of all patients (n=298) was 71 (IQR 60–80), 195 (65%) were female and serum sodium values on admission were 120 (IQR 116–123) mmol/l. 130 patients (44%) complained about nausea and 91 patients (30%) had a history of vomiting. Moreover 205 (69%) patients indicated generalized weakness and 175 (59%) fatigue. 92 patients (31%) had disturbed gait, 47 patients (16%) had a history of recurrent falls and 60 patients (20%) had an acute fall leading to hospitalization. Fractures were reported in 11 patients (4%). More severe symptoms such as seizures or focal neurological deficits were identified in 16 patients (5%) and 32 patients (11%) respectively. The most common comorbidity was hypertension (199 patients, 67%), 44 patients (15%) suffered from congestive heart failure, 64 patients (21%) had chronic renal failure, 82 patients (28%) had pulmonary diseases and 113 patients (38%) had a central nervous system disease. During hospitalisation 12 patients (4%) died and 103 patients (35%) needed treatment at the intensive care unit.
Conclusion: Severe hyponatremia is accompanied by a wide spectrum of symptoms. Most patients suffered from moderate symptoms reflecting rather chronic hyponatremia with brain cell adaptation. Patients presenting with severe hyponatremia had several comorbidities.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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