Study of spectrum of neurological manifestations in patients with hyponatremia: A prospective, observational study in a tertiary care hospital
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 4
Abstract
Abstract: Hyponatremia is a commonly observed disorder in hospitalized patients and linked to a poor prognosis and increased length of hospital stay. Prompt recognition and optimal management may reduce in-hospital mortality and improve patients’ quality of life. This prospective, observational, descriptive study was conducted to know spectrum of neurological manifestations in patients with hyponatremia and outcome in such patients after treatment in our hospital set up. 80 patients admitted during study period of 2 years, those who were fulfilling inclusion criteria, were enrolled in the study after institutional ethics committee approval. We noticed that, hyponatremia with neurological manifestations was found to be more prevalent among elderly patients than in younger patients (age group of 61-70 years - 38.75% and 71-80 years - 30%). It is more frequent in women (58.75% females & 41.25% males). Drowsiness, headache, confusion were more common symptoms, followed by seizures, disorientation, irritability, irrelevant talk, lethargy. 13 patients had seizures and we found a gradual increase in risk of seizures with falling serum sodium levels rather than a distinct cut off. In our study, commonest cause of hyponatremia was diuretics induced hyponatremia, followed by SIADH, renal loss, fluid overload, gastrointestinal loss, hypothyroidism, drug induced like chemotherapy. Overall mortality was found to be 13.75%, which is less than what was observed in previous literatures. Response to treatment in females was better than males, 88% improved with mortality of 12%, compared to males with mortality of 15%. To conclude, apart from mortality, hyponatremia prolongs the hospital stay significantly and increases the cost of medical care substantially. But a better outcome and minimal complications related to correction of hyponatremia can be obtained if the general guidelines of correction and a standardized regimen are followed and a word of caution should be maintained while prescribing diuretics in the elderly. Keywords:Hyponatremia, SIADH (Syndrome of Inappropriate Anti Diuretic Hormone secretion), Diuretics
Authors and Affiliations
SheelaOmprakash Pandey, PradipPadamsi Shah
Keywords
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