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Published in: BMC Emergency Medicine 1/2018

Open Access 01-12-2018 | Research article

Seasonal prevalence of hyponatremia in the emergency department: impact of age

Authors: Naohiko Imai, Kiyomi Osako, Nagayuki Kaneshiro, Yugo Shibagaki

Published in: BMC Emergency Medicine | Issue 1/2018

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Abstract

Background

Hyponatremia is one of the most commonly encountered electrolyte disorders in emergency department (ED). Seasonal fluctuations of the prevalence of hyponatremia has been reported. We investigated the impact of age on the seasonal prevalence of hyponatremia in the emergency department in Japan.

Methods

Total of 8377 patients presented to the ED between January 2015 and December 2016 were reviewed. The adult group aged between 18 and 64 years old consisted of 3656 patients and the elderly group aged over 65 years consisted of 4721 patients. Information collected included age, sex, serum sodium, and serum creatinine. Hyponatremia was defined as a serum sodium leve1 < 135 mEq/L and severe hyponatremia was defined as a serum sodium level < 125 mEq/L.

Results

Prevalence of hyponatremia was significantly higher in the elderly group than in the adult group (17.0% vs. 5.7%, p < 0.001). Similarly, the prevalence of severe hyponatremia was significantly higher in the elderly group than in the adult group (1.9% vs. 0.3%, p < 0.001). Prevalence of hyponatremia and severe hyponatremia was significantly higher in the elderly group than in the adult group in all seasons. In the elderly group, there was a significant correlation between weather high temperature during summer and prevalence of hyponatremia (r = 0.510, p = 0.011).

Conclusion

There was a major impact of age on the seasonal prevalence of hyponatremia and severe hyponatremia. Strategies to prevent hyponatremia and severe hyponatremia should be taken especially in the elderly patients during summer.
Literature
1.
go back to reference Giordano M, Ciarambino T, Castellino P, Malatino L, Di Somma S, Biolo G, et al. Diseases associated with electrolyte imbalance in the ED: age-related differences. Am J Emerg Med. 2016;34(10):1923–6.CrossRef Giordano M, Ciarambino T, Castellino P, Malatino L, Di Somma S, Biolo G, et al. Diseases associated with electrolyte imbalance in the ED: age-related differences. Am J Emerg Med. 2016;34(10):1923–6.CrossRef
2.
go back to reference Funk G-C, Lindner G, Druml W, Metnitz B, Schwarz C, Bauer P, et al. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2009;36(2):304–11.CrossRef Funk G-C, Lindner G, Druml W, Metnitz B, Schwarz C, Bauer P, et al. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2009;36(2):304–11.CrossRef
3.
go back to reference Hawkins RC. Age and gender as risk factors for hyponatremia and hypernatremia. Clin Chim Acta. 2003;337(1–2):169–72.CrossRef Hawkins RC. Age and gender as risk factors for hyponatremia and hypernatremia. Clin Chim Acta. 2003;337(1–2):169–72.CrossRef
4.
go back to reference Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med. 2006;119(1):71.e1–8.CrossRef Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med. 2006;119(1):71.e1–8.CrossRef
5.
go back to reference Sajadieh A, Binici Z, Mouridsen MR, Nielsen OW, Hansen JF, Haugaard SB. Mild hyponatremia carries a poor prognosis in community subjects. Am J Med. 2009;122(7):679–86.CrossRef Sajadieh A, Binici Z, Mouridsen MR, Nielsen OW, Hansen JF, Haugaard SB. Mild hyponatremia carries a poor prognosis in community subjects. Am J Med. 2009;122(7):679–86.CrossRef
6.
go back to reference Waikar SS, Mount DB, Curhan GC. Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med. 2009;122(9):857–65.CrossRef Waikar SS, Mount DB, Curhan GC. Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med. 2009;122(9):857–65.CrossRef
7.
go back to reference Giordano M, Ciarambino T, Castellino P, Malatino L, Cataliotti A, Rinaldi L, et al. Seasonal variations of hyponatremia in the emergency department: age-related changes. Am J Emerg Med. 2017;35(5):749–52.CrossRef Giordano M, Ciarambino T, Castellino P, Malatino L, Cataliotti A, Rinaldi L, et al. Seasonal variations of hyponatremia in the emergency department: age-related changes. Am J Emerg Med. 2017;35(5):749–52.CrossRef
8.
go back to reference Giordano M, Ciarambino T, Adinolf LE. Severe hyponatremia in the elderly: the seasonalvariability in the emergency department. Italian Journal of Emergency Medicine. 2018;1:1–14. Giordano M, Ciarambino T, Adinolf LE. Severe hyponatremia in the elderly: the seasonalvariability in the emergency department. Italian Journal of Emergency Medicine. 2018;1:1–14.
9.
go back to reference Lee CT, Guo HR, Chen JB. Hyponatremia in the emergency department. Am J Emerg Med. 2000;18(3):264–8.CrossRef Lee CT, Guo HR, Chen JB. Hyponatremia in the emergency department. Am J Emerg Med. 2000;18(3):264–8.CrossRef
10.
go back to reference Huwyler T, Stirnemann J, Vuilleumier N, Marti C, Dugas S, Poletti PA, et al. Profound hyponatraemia in the emergency department: seasonality and risk factors. Swiss Med Wkly. 2016;146:w14385. Huwyler T, Stirnemann J, Vuilleumier N, Marti C, Dugas S, Poletti PA, et al. Profound hyponatraemia in the emergency department: seasonality and risk factors. Swiss Med Wkly. 2016;146:w14385.
11.
go back to reference Pfortmueller CA, Funk G-C, Leichtle AB, Fiedler GM, Schwarz C, Exadaktylos AK, et al. Electrolyte disorders and in-hospital mortality during prolonged heat periods: a cross-sectional analysis. PLoS One. 2014;9(3):e92150.CrossRef Pfortmueller CA, Funk G-C, Leichtle AB, Fiedler GM, Schwarz C, Exadaktylos AK, et al. Electrolyte disorders and in-hospital mortality during prolonged heat periods: a cross-sectional analysis. PLoS One. 2014;9(3):e92150.CrossRef
12.
go back to reference Hoorn EJ, Lindemans J, Zietse R. Acute and concomitant deterioration of hyponatremia and renal dysfunction associated with heart and liver failure. Clin Nephrol. 2006;65(4):248–55.CrossRef Hoorn EJ, Lindemans J, Zietse R. Acute and concomitant deterioration of hyponatremia and renal dysfunction associated with heart and liver failure. Clin Nephrol. 2006;65(4):248–55.CrossRef
13.
go back to reference Rodenburg EM, Hoorn EJ, Ruiter R, Lous JJ, Hofman A, Uitterlinden AG, et al. Thiazide-associated hyponatremia: a population-based study. Am J Kidney Dis. 2013;62(1):67–72.CrossRef Rodenburg EM, Hoorn EJ, Ruiter R, Lous JJ, Hofman A, Uitterlinden AG, et al. Thiazide-associated hyponatremia: a population-based study. Am J Kidney Dis. 2013;62(1):67–72.CrossRef
14.
go back to reference Spital A. Diuretic-induced hyponatremia. Am J Nephrol. 1999;19(4):447–52.CrossRef Spital A. Diuretic-induced hyponatremia. Am J Nephrol. 1999;19(4):447–52.CrossRef
15.
go back to reference Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Electrolyte disorders in community subjects: prevalence and risk factors. Am J Med. 2013;126(3):256–63.CrossRef Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Electrolyte disorders in community subjects: prevalence and risk factors. Am J Med. 2013;126(3):256–63.CrossRef
16.
go back to reference Assen A, Abouem D, Vandergheynst F, Nguyen T, Taccone FS, Melot C. Hyponatremia at the emergency department: a case-control study. Minerva Anestesiol. 2014;80(4):419–28. Assen A, Abouem D, Vandergheynst F, Nguyen T, Taccone FS, Melot C. Hyponatremia at the emergency department: a case-control study. Minerva Anestesiol. 2014;80(4):419–28.
17.
go back to reference Malisova O, Bountziouka V, Panagiotakos DΒ, Zampelas A, Kapsokefalou M. Evaluation of seasonality on total water intake, water loss and water balance in the general population in Greece. J Hum Nutr Diet. 2013;26(Suppl 1):90–6.CrossRef Malisova O, Bountziouka V, Panagiotakos DΒ, Zampelas A, Kapsokefalou M. Evaluation of seasonality on total water intake, water loss and water balance in the general population in Greece. J Hum Nutr Diet. 2013;26(Suppl 1):90–6.CrossRef
18.
go back to reference Leshem M. Salt appetite is not increased in summer heat. Appetite. 2017;108:28–31.CrossRef Leshem M. Salt appetite is not increased in summer heat. Appetite. 2017;108:28–31.CrossRef
Metadata
Title
Seasonal prevalence of hyponatremia in the emergency department: impact of age
Authors
Naohiko Imai
Kiyomi Osako
Nagayuki Kaneshiro
Yugo Shibagaki
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2018
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-018-0182-5

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