Department of Geriatrics, Medical University of Bialystok, Fabryczna str. 27, 15-471 Bialystok, Poland.
Department of Geriatrics, Hospital of the Ministry of Interior and Administration in Bialystok, Fabryczna str.27, 15-471 Bialystok, Poland.
Nutrients. 2020 Feb 15;12(2):496. doi: 10.3390/nu12020496.
Dehydration is a concern among aging populations and can result in hospitalization and other adverse outcomes. There is a need to establish simple measures that can help in detecting low-intake dehydration (underhydration) in geriatric patients. The predictive performance of sodium, urea, glucose, and potassium to discriminate between patients with and without underhydration was evaluated using receiver-operating characteristic (ROC) curve analysis of data collected during the cross-sectional study of patients admitted to the geriatric ward. A total of 358 participants, for whom osmolarity could be calculated with the Khajuria and Krahn equation, were recruited to the study. Impending underhydration (osmolarity > 295 mmol/L) was diagnosed in 58.4% of cases. Serum sodium, urea, fasting glucose, and potassium (individual components of the equation) were significantly higher in dehydrated participants. The largest ROC area of 0.88 was obtained for sodium, and the value 140 mMol/L was found as the best cut-off value, with the highest sensitivity (0.80; 95% CI: 0.74-0.86) and specificity (0.83; 95% CI: 0.75-0.88) for prediction of underhydration. The ROC areas of urea, glucose, and potassium were significantly lower. Serum sodium equal to 140 mmol/L or higher appeared to be suggestive of impending underhydration in geriatric patients. This could be considered as the first-step screening procedure for detecting underhydration in older adults in general practice, especially when limited resources restrict the possibility of more in-depth biochemical assessments.
脱水是老年人群体关注的问题，可能导致住院和其他不良后果。因此，需要建立简单的措施，以帮助检测老年患者的低摄入脱水（脱水不足）。本研究通过对老年病房住院患者进行横断面研究收集的数据，采用受试者工作特征（ROC）曲线分析评估了钠、尿素、葡萄糖和钾对鉴别脱水患者和无脱水患者的预测性能。共有 358 名参与者符合纳入标准，可使用 Khajuria 和 Krahn 方程计算渗透压。结果发现，58.4%的患者有潜在脱水（渗透压>295mmol/L）。脱水患者的血清钠、尿素、空腹血糖和钾（方程的各个组成部分）显著升高。钠的 ROC 曲线下面积最大为 0.88，最佳截断值为 140mMol/L，预测脱水的灵敏度最高（0.80；95%CI：0.74-0.86），特异性最高（0.83；95%CI：0.75-0.88）。尿素、葡萄糖和钾的 ROC 曲线下面积明显较低。血清钠等于或高于 140mmol/L 似乎提示老年患者有潜在的脱水。这可以作为一般实践中检测老年人脱水的第一步筛选程序，特别是在资源有限限制更深入的生化评估可能性的情况下。
