Age-Related Variety in Electrolyte Levels and Prevalence of Dysnatremias and Dyskalemias in Patients Presenting to the Emergency Department

Abstract

Background: It was found that age and female gender are predisposing factors for hyponatremia in patients taking thiazides. Objective: To investigate whether a relationship exists between age and gender and serum sodium and potassium as well as the prevalence rates in a large population of patients presenting to the emergency department of a university hospital. Methods: In this retrospective analysis we gathered data on age, gender and current diuretic medication of all patients admitted to the emergency department of a large university hospital with measurement of serum sodium and potassium between January 1, 2009 and December 31, 2010. Prevalence rates of and risk factors for electrolyte disorders were calculated on the basis of these data. Results: A total of 20,667 patients were included in the analysis. Serum sodium levels declined significantly with increasing age while serum potassium rose, independent of diuretic medication at presentation. The prevalence rates of hyponatremia and hyperkalemia increased from 2.3% for hyponatremia in patients aged 16-21 years to 16.9% in patients aged >80 years and from 0.8% for hyperkalemia to 10.4%. In the regression analysis, age >60 years was a predictor for the presence of hyponatremia and hyperkalemia as was current use of diuretic medication. Male gender was associated with a decreased prevalence of hyponatremia and hypokalemia, while it was a predictor of hyperkalemia. Conclusions: Sodium levels were lower with increasing age, independent of diuretic intake, while potassium levels were higher. We found dramatically increasing prevalences of hyponatremia and hyperkalemia with increasing age, while no such effect could be found for hypernatremia and hypokalemia.

Die häufigsten Elektrolytstörungen in der Notaufnahme

“…Die Prävalenz ist maßgeblich vom Alter abhängig. So stieg sie in einer Untersuchung im Notaufnahmekollektiv von 2,3% bei 16-bis 21-Jährigen auf 16,9% bei über 80-Jährigen [4]. Ältere Frauen sind deutlich häufiger betroffen als ältere Männer.…”

Impact of Compound Hypertonic Saline Solution on Decompensated Heart Failure

“…But electrolytes in our skin, bones, internal organs, and muscles are actually decreasing. 27) This is similar to energy consumption by a battery, and although the voltage drop is not obvious, the electrolyte depletion is. Heart failure is a kind of self-increasing disease, or in other words, the heart function of patients with heart failure becomes more and more serious with age.…”

The prevalence of hyponatremia increases with ageing in an Italian emergency department population

“…Considering that we have chosen the threshold of 136 mmol/L for defining moderate hyponatremia, as suggested by Adrogué and Madias [1], it is predictable that the frequency of this condition would be substantially reduced using lower cut-offs (i.e., 12.3%, 8.7% and 2.6% using serum sodium values < 135 mmol/L, < 134 mmol/L and < 130 mmol/L, respectively), but still remaining higher than that reported in previous studies [5][6][7][8][9]. The prevalence of hyponatremia in ED patients was also found to be approximately 5-time higher than that observed in unselected outpatients of the same geographic area.…”

“…Assen et al performed a retrospective observational study including over 10,600 patients admitted to the ED over a 10-month period [8], and found hyponatremia (serum sodium < 130 mmol/L) in 2.4% of patients. More recently, Lindner reviewed data of all patients admitted to the emergency department of a large university hospital over a 2-year period (n = 20,667) [9], and concluded that the prevalence of hyponatremia increased from 2.3% in patients aged 16-21 years up to 16.9% in those aged > 80 years and older.…”

“…The emergency department (ED) is another healthcare setting where the observation of hyponatremia is particularly frequent, although the overall prevalence varies widely among the different clinical investigations, ranging from to 2.4% to 16.9% [5][6][7][8][9]. As such, the aim of this study was to establish the frequency of moderate and severe hyponatremia in an Italian ED, to compare it with the prevalence of this condition in unselected outpatients, and to define the distribution of sodium disturbances according to the age of the ED population.…”