Seasonal variations of hyponatremia in the emergency department: Age-related changes

Abstract Study o bjective We investigated seasonal prevalence of hyponatremia in the emergency department (ED). Design A cross-sectional study using clinical chart review. Setting University Hospital ED, with approximately 28 000 patient visits a year. Type of participants We reviewed 15 049 patient...

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Bibliographic Details
Published in:The American journal of emergency medicine 2017-05, Vol.35 (5), p.749-752
Main Authors: Giordano, Mauro, MD, Ciarambino, Tiziana, MD, Castellino, Pietro, MD, Malatino, Lorenzo, MD, Cataliotti, Alessandro, MD, Rinaldi, Luca, MD, Paolisso, Giuseppe, MD, Adinolfi, Luigi Elio, MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adults
Age
Age Factors
Annual variations
Blood
Cross-Sectional Studies
Diuretics - adverse effects
Electrolytes
Emergencies
Emergency
Emergency medical care
Emergency medical services
Emergency Medical Services - statistics & numerical data
Female
Geriatrics
Hospitalization - statistics & numerical data
Hospitals
Hot Temperature - adverse effects
Hot weather
Humans
Hyponatremia
Hyponatremia - epidemiology
Hyponatremia - prevention & control
Ingestion
Italy - epidemiology
Laboratories
Male
Medical personnel
Middle Aged
Mortality
Older people
Patients
Prevalence
Renal function
Risk Factors
Salts
Seasonal variations
Seasons
Sodium
Summer
Temperature effects
Weather
Young Adult
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Summary:Abstract Study o bjective We investigated seasonal prevalence of hyponatremia in the emergency department (ED). Design A cross-sectional study using clinical chart review. Setting University Hospital ED, with approximately 28 000 patient visits a year. Type of participants We reviewed 15 049 patients, subdivided in 2 groups: the adult group consisting of 9822 patients aged between 18 and 64 years old and the elderly group consisting of 5227 patients aged over 65 years presenting to the ED between January 1st, 2014 and December 31st, 2015. Intervention Emergency patients were evaluated for the presence of hyponatremia by clinical chart review. Measurements and main results Hyponatremia was defined as a serum sodium level < 135 mmol/l. Mean monthly prevalence of hyponatremia was of 3.74 ± 0.5% in the adult group and it was significantly increased to 10.3 ± 0.7% in the elderly group (p < 0.05 vs adults). During the summer, hyponatremia prevalence was of 4.14 ± 0.2% in adult and markedly increased to 12.52 ± 0.7% (zenith) in elderly patients (p < 0.01 vs adult group; p < 0.05 vs other seasons in elderly group). In the elderly group, we reported a significant correlation between weather temperature and hyponatremia prevalence (r: 0.491; p < 0.05). Conclusion We observed a major influence of climate on the prevalence of hyponatremia in the elderly in the ED. Decline in renal function, salt loss, reduced salt intake and increased water ingestion could all contribute to developing hyponatremia in elderly patients during the summer. These data could be useful for emergency physicians to prevent hot weather-induced hyponatremia in the elderly.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2017.01.018