Nankabirwa Harriet, Kalyesubula Robert, Ssinabulya Isaac, Katabira Elly T, Cumming Robert G
Makerere University College of Health Sciences, Kampala, Uganda.
School of Public Health, University of Sydney, Sydney, Queensland, Australia.
BMJ Open. 2016 May 17;6(5):e009775. doi: 10.1136/bmjopen-2015-009775.
Hyponatraemia is a common electrolyte disturbance among older patients. We determined the prevalence of and factors associated with hyponatraemia among older patients with predominantly acute decompensated heart failure attending a tertiary hospital in Kampala, Uganda.
Main study aim: (1) to determine the prevalence of hyponatraemia among patients aged 60 years and above with heart failure attending Mulago National Referral Hospital; (2) to describe the factors associated with hyponatraemia among patients aged 60 years and above with heart failure attending Mulago National Referral Hospital.
The study was conducted in one tertiary hospital located in the northeast of Kampala, Uganda.
400 adults aged 60 years and above were identified for the study. Of these, 188 were excluded as they did not fulfil the inclusion criteria and one declined to participate, leaving a final study group of 211 older adults aged 60 years and above, with a clinical diagnosis of heart failure using Framingham's criteria.
The prevalence of hyponatraemia was 24.2% (51/211). Hyponatraemia was mainly found in patients with mild-to-moderate heart failure, New York Heart Association classes 2 and 3. Of the 51 patients with hyponatraemia, 27 (52.9%) had mild hyponatraemia, while 24 (47.1%) had moderate to severe hyponatraemia of 130-125 mmol/L. History of vomiting (OR=2.94, 95% CI 1.29 to 6.70, p=0.010) and use of loop diuretics (OR=2.71, 95% CI 1.13 to 6.52, p=0.026) were identified as independent factors associated with hyponatraemia among older patients with heart failure.
Our study revealed a relatively high prevalence of hyponatraemia among older patients with mild to moderate heart failure. Patients presenting with a history of vomiting from any cause or use of loop diuretics were more likely to have hyponatraemia.
低钠血症是老年患者中常见的电解质紊乱。我们确定了乌干达坎帕拉一家三级医院中以急性失代偿性心力衰竭为主的老年患者低钠血症的患病率及相关因素。
主要研究目标：（1）确定穆拉戈国家转诊医院60岁及以上心力衰竭患者中低钠血症的患病率；（2）描述穆拉戈国家转诊医院60岁及以上心力衰竭患者中与低钠血症相关的因素。
该研究在乌干达坎帕拉东北部的一家三级医院进行。
确定400名60岁及以上的成年人参与研究。其中，188人因不符合纳入标准被排除，1人拒绝参与，最终研究组为211名60岁及以上的老年人，根据弗雷明汉标准临床诊断为心力衰竭。
低钠血症的患病率为24.2%（51/211）。低钠血症主要见于轻度至中度心力衰竭患者，纽约心脏协会心功能分级为2级和3级。在51例低钠血症患者中，27例（52.9%）为轻度低钠血症，24例（47.1%）为130 - 125 mmol/L的中度至重度低钠血症。呕吐史（比值比=2.94，95%可信区间1.29至6.70，p = 0.010）和使用袢利尿剂（比值比=2.71，95%可信区间1.13至6.52，p = 0.026）被确定为老年心力衰竭患者低钠血症的独立相关因素。
我们的研究显示，轻度至中度心力衰竭的老年患者中低钠血症患病率相对较高。有任何原因导致的呕吐史或使用袢利尿剂的患者更易发生低钠血症。
