Naka Tamayo, Kohagura Kentaro, Kochi Masako, Ohya Yusuke
Nishizaki Hospital, Itoman, Okinawa, Japan.
Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Clin Exp Nephrol. 2018 Dec;22(6):1404-1410. doi: 10.1007/s10157-018-1607-x. Epub 2018 Jun 27.
Hyponatremia is common among elderly patients. This study aimed to examine the prognostic value of hyponatremia among elderly residents in a geriatric facility.
We retrospectively examined the association between serum sodium levels and mortality among 118 residents (82% female, mean age 85.5 years) in a single geriatric health service facility. We defined hyponatremia as Na < 135 mEq/L. On the basis of single measurements of serum sodium at periodic examinations, the patients were divided into hyponatremia and non-hyponatremia groups. Multivariable Cox proportional hazards models were used to evaluate the effect of hyponatremia on mortality from May 2005 to April 2007.
Thirty-three patients (28%) had hyponatremia. Over a 1-year follow-up period, the cumulative survival rate was significantly lower in patients with hyponatremia than in those without hyponatremia. In a multivariate analysis, including traditional risk factors for death, hyponatremia was associated with an increased mortality risk (adjusted hazard ratio 2.73; 95% confidence interval 1.01-5.16; p = 0.047).
Hyponatremia is common and is a predictor of mortality in the near future among very elderly residents of a geriatric facility.
低钠血症在老年患者中很常见。本研究旨在探讨老年护理机构中低钠血症对老年居民的预后价值。
我们回顾性研究了一家老年健康服务机构中118名居民（82%为女性，平均年龄85.5岁）的血清钠水平与死亡率之间的关联。我们将低钠血症定义为血清钠<135 mEq/L。根据定期检查时单次测量的血清钠水平，将患者分为低钠血症组和非低钠血症组。使用多变量Cox比例风险模型评估2005年5月至2007年4月期间低钠血症对死亡率的影响。
33名患者（28%）患有低钠血症。在1年的随访期内，低钠血症患者的累积生存率显著低于非低钠血症患者。在包括传统死亡风险因素的多变量分析中，低钠血症与死亡风险增加相关（调整后的风险比为2.73；95%置信区间为1.01-5.16；p = 0.047）。
低钠血症很常见，是老年护理机构中高龄居民近期死亡的一个预测因素。
