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Dysnatraemias in the emergency room: Undetected, untreated, unknown?

Dysnatriämien an der Notfallaufnahme: Unentdeckt, unbehandelt, unbekannt?

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Zusammenfassung

HINTERGRUND: Hypo- und Hypernatriämie sind die häufigsten Elektrolytstörungen im Krankenhaus und wurden mit erhöhter Mortalität assoziiert. Zur Zeit gibt es nur wenige Daten zur Prävalenz der Dysnatriämien an der Notfallaufnahme sowie zu den Charakteristika der Patienten mit Hypo- und Hypernatriämien. METHODIK: In diese retrospektive Studie wurden Patienten welche zwischen 01.09.2010 und 30.11.2010 an der Notfallaufnahme einer Universitätsklinik eine Bestimmung des Serum-Natriums erhielten eingeschlossen. RESULTATE: Insgesamt wurden während des Studienzeitraumes an 3.182 Patienten Bestimmungen des Serum-Natriums durchgeführt. 124 Patienten (4 %) wiesen bei Aufnahme in die Notfallaufnahme eine Hyponatriämie auf, während 400 Patienten (13 %) eine Hypernatriämie aufwiesen. Es zeigte sich kein Unterschied im Alter zwischen jenen Patienten welche eine Hypernatriämie aufwiesen und jenen welche normonaträm waren. Patienten mit Hyponatriämie waren hingegen signifikant älter. SCHLUSSFOLGERUNGEN: Beinahe 1 von 5 Patienten weist bei Aufnahme an der Notfallaufnahme eine Störung des Natriumhaushalts auf. Im Gegensatz zu hospitalisierten Patienten war an der Notfallaufnahme die Prävalenz der Hypernatriämie bedeutend grösser als jene der Hyponatriämie. Überraschenderweise waren Patienten mit Hyponatriämie signifikant älter als jene mit Hypernatriämie und jene mit normalen Serum-Natriumwerten.

Summary

BACKGROUND: Hypo- and hypernatraemia are the most common electrolyte disorders in hospitalized patients and have been associated with increased mortality. However, data on the prevalence of dysnatraemias in the emergency room and the characteristics of patients presenting with them are rare. METHODS: In this retrospective study, we analyzed data from patients who presented to the emergency department of a large tertiary university hospital between September 1st 2010 and November 30th 2010 and who received measurement of serum sodium. RESULTS: 3,182 patients received measurement of serum sodium during the three-month study period. 124 patients (4%) presented with hyponatraemia on admission to the emergency department while 400 patients (13%) presented with hypernatraemia. While there was no difference in age between patients with hypernatraemia and those who were normonatraemic, patients with hyponatraemia were significantly older. CONCLUSION: Dysnatraemias are present in almost 1 in 5 patients who presented to the emergency department. Contrarily to patients who are already hospitalized, hypernatraemia was by far more common than hyponatraemia in patients at the emergency department. Surprisingly, patients with hyponatraemia were significantly older than normonatraemic patients while there was no age difference in hypernatraemic patients. Dysnatraemias are common in the emergency room and further studies are indicated to evaluate the causes and the impact on outcome of patients.

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Authors and Affiliations

  1. Department of Nephrology and Hypertension, Inselspital, University of Bern, Bern, Switzerland

    Spyridon Arampatzis & Gregor Lindner

  2. Department of Emergency Medicine, Inselspital, University of Bern, Bern, Switzerland

    Aristomenis Exadaktylos & Heinz Zimmermann

  3. Department of Laboratory Medicine, Inselspital, University of Bern, Bern, Switzerland

    Daniela Buhl

  4. Department of Internal Medicine, Inselspital, University of Bern, Bern, Switzerland

    Gregor Lindner

Authors
  1. Spyridon Arampatzis
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  2. Aristomenis Exadaktylos
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  3. Daniela Buhl
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  4. Heinz Zimmermann
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  5. Gregor Lindner
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Correspondence to Aristomenis Exadaktylos.

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Arampatzis, S., Exadaktylos, A., Buhl, D. et al. Dysnatraemias in the emergency room: Undetected, untreated, unknown?. Wien Klin Wochenschr 124, 181–183 (2012). https://doi.org/10.1007/s00508-011-0108-7

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  • DOI: https://doi.org/10.1007/s00508-011-0108-7

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