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Hypernatremia in the elderly: relation to infection and mortality
Journal of the American Geriatrics Society
|April 1, 1981
Summary
Elderly patients with hypernatremia face high mortality, but infection significantly impacts survival. Early antibiotics may reduce deaths in these dehydration cases.
Area of Science:
- Geriatrics
- Internal Medicine
- Nephrology
Background:
- Dehydration and hypernatremia are serious conditions in the elderly.
- Hypernatremia in older adults is associated with significant morbidity and mortality.
- County hospital data reveals high mortality rates in elderly patients with hypernatremia.
Purpose of the Study:
- To review the outcomes of elderly patients admitted with dehydration and hypernatremia.
- To identify factors contributing to mortality in this patient population.
- To evaluate the role of infection in hypernatremia-related deaths.
Main Methods:
- Retrospective review of medical records.
- Analysis of 23 elderly patients admitted with dehydration and hypernatremia.
- Comparison of mortality rates between infected and non-infected patients.
Main Results:
- Overall mortality was 48%.
- The degree of hypernatremia did not correlate with mortality.
- Two-thirds of patients with acute bacterial infections died, while all non-infected patients survived.
- One patient presented with a serum sodium level of 202 mEq/L, the highest reported in an adult.
Conclusions:
- Infection is a critical factor in the high mortality of elderly patients with hypernatremia.
- Infection may not be clinically apparent upon hospital admission.
- Prompt and effective antibiotic treatment is proposed as a strategy to decrease mortality.