Himmelstein D U, Jones A A, Woolhandler S
J Am Geriatr Soc. 1983 Aug;31(8):466-71. doi: 10.1111/j.1532-5415.1983.tb05118.x.
In order to determine the antecedents of hypernatremic dehydration the authors reviewed the records of 56 patients with this condition at two public hospitals, one of which includes a large chronic care facility. Twenty-nine patients developed hypernatremic dehydration while at nursing homes. All cases came from proprietary nursing homes, although proprietaries account for only 88 per cent of nursing home beds in the community studied (P less than 0.05). There was a cluster of patients from two nursing homes. Sixteen patients admitted from home all showed evidence of inadequate care prior to admission. Eleven patients became hypernatremic while in acute care hospitals. No patient in the public chronic care facility developed hypernatremic dehydration during the period studied. The average serum sodium concentration of patients transferred from nursing homes was significantly higher than that of patients who developed hypernatremic dehydration at home or in acute care hospitals. It is concluded that hypernatremic dehydration in an institutionalized patient may be an indicator of inadequate care, which should prompt further investigation of the living conditions of the patient.
为了确定高钠血症性脱水的病因，作者回顾了两家公立医院56例患有该病症患者的记录，其中一家医院设有大型慢性病护理机构。29例患者在疗养院期间出现高钠血症性脱水。所有病例均来自私立疗养院，尽管在研究的社区中，私立疗养院仅占疗养院床位的88%（P<0.05）。有一组患者来自两家疗养院。16例从家中入院的患者在入院前均显示出护理不足的证据。11例患者在急症医院期间出现高钠血症。在所研究的期间内，公立慢性病护理机构中没有患者发生高钠血症性脱水。从疗养院转来的患者的平均血清钠浓度显著高于在家中或急症医院发生高钠血症性脱水的患者。得出的结论是，机构化患者中的高钠血症性脱水可能表明护理不足，这应促使对患者的生活条件进行进一步调查。
