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Dissertation Chapters | Medicine | India | Volume 12 Issue 3, March 2023
Clinical and Etiological Profile of Hyponatremia in ICU Patients at Tertiary Care Hospital
Kute Bramhadev Shivaji [2] | Shejal Suhas Sudam | Bhaisare Sunil D.
Abstract: Aim: To study the clinical profile of Hyponatremia in acute illnesses and factors associated with mortality in critically ill patients at tertiary care Hospital. Introduction: Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is frequently encountered in the intensive care setting. [1, 6]Treatment varies significantly according to the timing of onset and aetiology of the disorder. Inadequate or improper treatment may lead to brain oedema or demyelination with life-threatening consequences. Appropriate treatment rendered in a timely manner can result in complete recovery in many cases. Materials and Methods: Single centric, prospective observational study conducted in Department of Medicine of a tertiary care hospital in period of 18 months (June 2020 till Dec 2021). Total 250 patients diagnosed with hyponatremia (serum sodium < 135 mmol/L), aged more than 12 years with irrespective of gender admitted to Medicine ICUs at our hospital within 48 hours of admission were included in our study. Patients on diuretic therapy, Patients who Patients develop hyponatremia later on during the course in ward (after 48 hours of admission) & patients with pseudo-hyponatremia were excluded. Results: The most common cause of hyponatremia was SIADH in our study (66.4%). SIADH was due to infection in (69.8%) of the patients and due to stroke in (30.2%) of the patients. Next most common cause was renal failure (11.6%), severe sepsis (7.2%), trauma (6%), liver failure (3.2%), thiazide diuretics (3.2%) and hypothyroidism (2.4%). The most common precipitating factor in our patients was vomiting (48.4%). The most common presenting complaint of our patients was abnormal behaviour (41.6%). It was observed that (86%) of the patients who died were aged 61 to 80 years, diabetes mellitus and hypertension was more common among patients who died, while 41% of the patients who were discharged were aged 41 to 60 years. In addition, mortality among female patients was significantly higher (p value < 0.01). The severity of hyponatremia was not found to be significantly associated with mortality among the patients (p value = 0.86). Conclusion: The most common presenting complaint was abnormal behaviour, 22.4% were drowsy, SIADH was the most common cause, 46.8% had severe hyponatremia, 42.4% were hypervolemic, and 24.4% stayed in ICU for more than 5 days. Mortality rate was 20% and was not associated with severity of hyponatremia, though it was high in patients with severe hyponatremia. Older age, female gender, past medical history of hypertension and diabetes mellitus, high blood pressure, drowsiness at presentation, extensor planter, pus cells in urine routine, and more than 4 weeks of ICU stay were associated with mortality.
Keywords: Hyponatremia, ICU (Intensive Care Unit), acute illnesses, Mortality
Edition: Volume 12 Issue 3, March 2023,
Pages: 385 - 389