Hypernatremia in the aging: causes, manifestations, and outcome

Area of Science:

• Nephrology
• Geriatrics
• Internal Medicine

Background:

• Hypernatremia (serum sodium > 150 mEq/L) is a significant electrolyte disorder in hospitalized adults.
• Its incidence, clinical impact, and optimal management strategies require further elucidation, particularly concerning age-related factors.

Purpose of the Study:

• To investigate the incidence, clinical features, morbidity, and mortality of hypernatremia in hospitalized adults.
• To evaluate the impact of age on hypernatremia and determine the optimal correction velocity for improved clinical outcomes.

Main Methods:

• A retrospective review of all adult patients admitted or developing hypernatremia (Na+ > 150 mEq/L) over a 6-month period.
• Data collected included demographics, diagnoses, length of stay, treatment, and outcomes. The velocity of hypernatremia correction was analyzed.

Main Results:

• Hypernatremia occurred in 3.46% (111/3209) of hospitalizations, with 65 admitted and 45 developing it during hospitalization.
• Associated electrolyte disorders like hypokalemia (49%) and hypercalcemia (6%) were common. Overall mortality was high at 48.6%, not influenced by age.
• Correction within 72 hours significantly improved mental status, with etiology varying by age and febrile illness being common in the elderly.

Conclusions:

• Hypernatremia is a prevalent and serious condition in elderly hospitalized patients, associated with substantial mortality and morbidity.
• Prompt infection treatment and adequate hydration are crucial preventive measures in this demographic.
• Timely correction of hypernatremia, ideally within 72 hours, enhances mental recovery.