Shimizu Miyuki, Kinoshita Kensuke, Hattori Kazuya, Ota Yoshio, Kanai Takao, Kobayashi Hiroyuki, Tokuda Yasuharu
Terumo Corporation R&D Headquarters, Japan.
Intern Med. 2012;51(10):1207-10. doi: 10.2169/internalmedicine.51.7056. Epub 2012 May 15.
Dehydration is a common condition and frequent cause of hospitalization in older people, despite the caregiver's high attention in attempt to avoid its occurrence. In this study, various physical signs were examined as clinical signs of dehydration in elderly.
A prospective observational study was conducted in an acute care teaching hospital. Consecutive elderly patients who were admitted to the Department of Medicine were evaluated. Dehydration was defined as a calculated serum osmolality above 295 mOsm/L. The patients diagnosed as dehydrated or not dehydrated were observed for physical signs of dehydration. Data of blood and urine chemistry analysis were also compared between the two groups.
A total of 27 elderly patients admitted with acute medical conditions were included in this study. For the physical signs, dry axilla had moderate sensitivity (44%) and excellent specificity (89%) to detect dehydration. Sunken eyes and delayed capillary refill time also showed relatively good specificity (83%). For laboratory data, the mean concentrations of serum sodium of the dehydrated group (146 mEq/L) was significantly higher (p<0.01) than those of the non-dehydrated group (134 mEq/L).
Physical signs of dehydration in elderly showed relatively good specificity but poor sensitivity. The evaluation of the axillary moisture could help assess dehydration as well as laboratory data analysis such as serum sodium concentration.
脱水是一种常见病症，也是老年人住院的常见原因，尽管护理人员高度关注以避免其发生。在本研究中，对各种体征作为老年人脱水的临床体征进行了检查。
在一家急性护理教学医院进行了一项前瞻性观察研究。对连续入住内科的老年患者进行评估。脱水定义为计算出的血清渗透压高于295 mOsm/L。观察诊断为脱水或未脱水的患者的脱水体征。还比较了两组的血液和尿液化学分析数据。
本研究共纳入27例因急性病症入院的老年患者。对于体征，腋窝干燥对检测脱水具有中等敏感性（44%）和出色的特异性（89%）。眼窝凹陷和毛细血管再充盈时间延迟也显示出相对较好的特异性（83%）。对于实验室数据，脱水组的血清钠平均浓度（146 mEq/L）显著高于未脱水组（134 mEq/L）（p<0.01）。
老年人脱水的体征显示出相对较好的特异性但敏感性较差。腋窝湿度评估有助于评估脱水情况以及血清钠浓度等实验室数据分析。
