Hypernatremia in the elderly: relation to infection and mortality.

The records of 23 elderly patients admitted to a county hospital with dehydration and hypernatremia were reviewed. One of these patients had the highest serum sodium level (202 mEq/L) reported in an adult. The overall mortality of 48 percent was not related to the degree of hypernatremia. However, two-thirds of the 17 patients with acute bacteria infections died, whereas all 5 noninfected patients survived. Infection was not always apparent at the time of admission to the hospital. It is proposed that early and appropriate antibiotic therapy may reduce the high mortality associated with hypernatremia in the elderly.