Department of Geriatrics and Internal Medicine, Hospital Hochzirl, Zirl, Austria.
Gerontology. 2012;58(5):430-40. doi: 10.1159/000339100. Epub 2012 Jun 21.
To study whether geriatric patients with mild-to-moderate hyponatremia (≤131 mmol/l) reveal different outcomes in structured tests for functional and cognitive impairments, depression and malnutrition compared to normonatremic patients.
Single-center, retrospective case control study.
The study was conducted in a Geriatric Evaluation and Management Unit of a Department for Geriatrics and Internal Medicine.
We included 2,880 elderly patients (75.6% female, mean age 78.6 ± 6.98 years), consecutively admitted to the GEMU primarily or from another hospital or emergency department. Results were compared between a group of 129 patients with mild-to-moderate hyponatremia (118-131 mmol/l) and an age- and sex-matched control group of 129 patients with normal serum sodium values (>135 mmol/l). To assess functional and cognitive status, depression and malnutrition we used standardized tests of a geriatric assessment.
16.7% (n = 477) of the total 2,880 patients were hyponatremic (≤135 mmol/l), 4.5% (n = 129) revealed moderate hyponatremia. Compared to the control group, these patients had significantly worse results in all tests of the Geriatric Assessment, including Activities of Daily Living, Mini Mental State Examination, Clock Completion Test, Geriatric Depression Score, Tinetti Mobility Test and the Timed Up&Go Test and the Mini Nutritional Assessment. Comorbidities were assessed by the Charlson Comorbidity Index and the Cumulative Illness Rating Scale with no significant difference between the two groups. The hyponatremic patients received significantly more medications than the normonatremic control group, but we could not find a significant difference with respect to the use of a distinct single drug therapy.
We were able to demonstrate that geriatric patients with mild-to-moderate hyponatremia revealed a significantly worse outcome in all standardized tests of the geriatric assessment compared to a normonatremic control group. Serum sodium levels should therefore be considered when interpreting common tests of geriatric assessment.
研究轻度至中度低钠血症（≤131mmol/L）的老年患者在功能和认知障碍、抑郁和营养不良的结构化测试中与正常血钠患者相比是否表现出不同的结果。
单中心回顾性病例对照研究。
该研究在老年评估和管理单位的老年科和内科进行。
我们纳入了 2880 名老年患者（75.6%为女性，平均年龄 78.6±6.98 岁），他们主要或从其他医院或急诊部门连续入院到 GEMU。将 129 名轻度至中度低钠血症（118-131mmol/L）患者的结果与年龄和性别匹配的 129 名正常血清钠值（>135mmol/L）的对照组进行比较。为了评估功能和认知状态、抑郁和营养不良，我们使用了老年评估的标准化测试。
在 2880 名患者中，16.7%（n=477）存在低钠血症（≤135mmol/L），4.5%（n=129）出现中度低钠血症。与对照组相比，这些患者在老年评估的所有测试中，包括日常生活活动、简易精神状态检查、时钟完成测试、老年抑郁评分、蒂内蒂活动测试和计时起立行走测试以及微型营养评估，结果明显更差。通过 Charlson 合并症指数和累积疾病评分评估合并症，两组之间没有显著差异。低钠血症患者接受的药物治疗明显多于正常血钠对照组，但我们没有发现使用特定单一药物治疗方面的显著差异。
我们能够证明，与正常血钠对照组相比，轻度至中度低钠血症的老年患者在所有老年评估的标准化测试中表现出明显更差的结果。因此，在解释常见的老年评估测试时，应考虑血清钠水平。
