Hyponatremia is a frequent electrolyte abnormality in hospital practice. The aim of this study is to assess the prevalence, investigations and outcome of hyponatremia at Mater Dei Hospital (MDH), Malta. All admissions throughout the month of January 2015 were analysed. Patients with low sodium on admission were audited and data collected from iSoft clinical manager and discharge letters to assess if the relevant investigations and treatment changes were performed to correct the hyponatremia. There were 1905 casualty admissions. 16.5% had hyponatremia on admission. 8.55% had mild (131-134 mmol/L), 5% moderate (125-130mmol/L) and 2.56% severe (<125mmol/L) hyponatremia. In the severe cohort 69.7% patients had glucose taken, 57.1% had thyroid function tests (TFTs), 46.5% had serum osmolality, 14% had urine osmolality and electrolytes taken and 18% had serum cortisol. Rise in sodium in 24 hrs ranged from 1 to 24 mmol with a mean of 8.72 mmol/L. In the moderate cohort 67% had glucose taken, 45.9% had TFTs and 43.5% serum osmolality. Rise in sodium in 24 hrs ranged from 1 to 14 mmol with a mean of 4.7 mmol/L. In the mild cohort 66.7% had glucose taken, 27.4% had TFTs and 35.5% had serum osmolality. Rise in sodium in 24 hrs ranged from 1 to 16 mmol with a mean of 4.1 mmol/L. This study shows the current poor management of severely hyponatremic patients in our medical and surgical wards. There is a definite need to set up local guidelines for the management of such a common electrolyte abnormality.
| DOI | 10.11648/j.sjcm.20160505.11 |
| Published in | Science Journal of Clinical Medicine (Volume 5, Issue 5, September 2016) |
| Page(s) | 41-45 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Poor Management, Severe, Hyponatremia
| [1] | Baran D, Hutchinson T. The outcome of hyponatremia in a general hospital population. Clin Nephrol. 1984; 22(2): 72-6. |
| [2] | Gill G, Leese G. Hyponatraemia: biochemical and clinical perspectives. Postgraduate Medical Journal. 1998; 74(875): 516-523. |
| [3] | Siddique H, Kaja R, Daggett P. An audit on the management of severe hyponatremia in a hospital population. Presented at 197th Meeting of the Society for Endocrinology 2006, London, UK Endocrine Abstracts. 2006; 12: P9. |
| [4] | Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. European Journal of Endocrinology. 2014;171(1):X1-X1. |
| [5] | Simon E, Mehrdad Hamrahian S, Teran F. Hyponatremia: Practice Essentials, Pathophysiology, Epidemiology [Internet]. Emedicine.medscape.com. 2016 [cited 28 August 2016]. Available from: http://emedicine.medscape.com/article/242166-overview |
| [6] | Sterns R. Diagnostic evaluation of adults with hyponatremia [Internet]. Uptodate.com. 2016 [cited 28 August 2016]. Available from: http://www.uptodate.com/contents/diagnostic-evaluation-of-adults-with-hyponatremia |
| [7] | Ghaffar I, Downie P, Ahmad B, Thorogood N, Thomas P, Bradley K. Hyponatremia: an audit of the initial investigation and management. Endocrine Abstracts. 2015;. |
| [8] | Saeed B. Severe hyponatraemia: investigation and management in a district general hospital. Journal of Clinical Pathology. 2002; 55(12): 893-896. |
| [9] | Clayton J. Severe hyponatraemia in medical in-patients: aetiology, assessment and outcome. QJM. 2006; 99(8): 505-511. |
| [10] | Reynolds RM, Padfield PL & Seckl JR. Disorders of sodium balance. BMJ 2006 332 (7543) 702–705. |
| [11] | Reynolds RM & Seckl JR. Hyponatraemia for the clinical endocrinologist. Clin Endocrinol (Oxf) 2005 63 (4) 366–374. |
APA Style
Annalisa Montebello. (2016). A Study of the Management of Hyponatremia at Mater Dei Hospital, Malta. Science Journal of Clinical Medicine, 5(5), 41-45. https://doi.org/10.11648/j.sjcm.20160505.11
ACS Style
Annalisa Montebello. A Study of the Management of Hyponatremia at Mater Dei Hospital, Malta. Sci. J. Clin. Med. 2016, 5(5), 41-45. doi: 10.11648/j.sjcm.20160505.11
AMA Style
Annalisa Montebello. A Study of the Management of Hyponatremia at Mater Dei Hospital, Malta. Sci J Clin Med. 2016;5(5):41-45. doi: 10.11648/j.sjcm.20160505.11
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.sjcm.20160505.11,
author = {Annalisa Montebello},
title = {A Study of the Management of Hyponatremia at Mater Dei Hospital, Malta},
journal = {Science Journal of Clinical Medicine},
volume = {5},
number = {5},
pages = {41-45},
doi = {10.11648/j.sjcm.20160505.11},
url = {https://doi.org/10.11648/j.sjcm.20160505.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20160505.11},
abstract = {Hyponatremia is a frequent electrolyte abnormality in hospital practice. The aim of this study is to assess the prevalence, investigations and outcome of hyponatremia at Mater Dei Hospital (MDH), Malta. All admissions throughout the month of January 2015 were analysed. Patients with low sodium on admission were audited and data collected from iSoft clinical manager and discharge letters to assess if the relevant investigations and treatment changes were performed to correct the hyponatremia. There were 1905 casualty admissions. 16.5% had hyponatremia on admission. 8.55% had mild (131-134 mmol/L), 5% moderate (125-130mmol/L) and 2.56% severe (<125mmol/L) hyponatremia. In the severe cohort 69.7% patients had glucose taken, 57.1% had thyroid function tests (TFTs), 46.5% had serum osmolality, 14% had urine osmolality and electrolytes taken and 18% had serum cortisol. Rise in sodium in 24 hrs ranged from 1 to 24 mmol with a mean of 8.72 mmol/L. In the moderate cohort 67% had glucose taken, 45.9% had TFTs and 43.5% serum osmolality. Rise in sodium in 24 hrs ranged from 1 to 14 mmol with a mean of 4.7 mmol/L. In the mild cohort 66.7% had glucose taken, 27.4% had TFTs and 35.5% had serum osmolality. Rise in sodium in 24 hrs ranged from 1 to 16 mmol with a mean of 4.1 mmol/L. This study shows the current poor management of severely hyponatremic patients in our medical and surgical wards. There is a definite need to set up local guidelines for the management of such a common electrolyte abnormality.},
year = {2016}
}
TY - JOUR T1 - A Study of the Management of Hyponatremia at Mater Dei Hospital, Malta AU - Annalisa Montebello Y1 - 2016/10/15 PY - 2016 N1 - https://doi.org/10.11648/j.sjcm.20160505.11 DO - 10.11648/j.sjcm.20160505.11 T2 - Science Journal of Clinical Medicine JF - Science Journal of Clinical Medicine JO - Science Journal of Clinical Medicine SP - 41 EP - 45 PB - Science Publishing Group SN - 2327-2732 UR - https://doi.org/10.11648/j.sjcm.20160505.11 AB - Hyponatremia is a frequent electrolyte abnormality in hospital practice. The aim of this study is to assess the prevalence, investigations and outcome of hyponatremia at Mater Dei Hospital (MDH), Malta. All admissions throughout the month of January 2015 were analysed. Patients with low sodium on admission were audited and data collected from iSoft clinical manager and discharge letters to assess if the relevant investigations and treatment changes were performed to correct the hyponatremia. There were 1905 casualty admissions. 16.5% had hyponatremia on admission. 8.55% had mild (131-134 mmol/L), 5% moderate (125-130mmol/L) and 2.56% severe (<125mmol/L) hyponatremia. In the severe cohort 69.7% patients had glucose taken, 57.1% had thyroid function tests (TFTs), 46.5% had serum osmolality, 14% had urine osmolality and electrolytes taken and 18% had serum cortisol. Rise in sodium in 24 hrs ranged from 1 to 24 mmol with a mean of 8.72 mmol/L. In the moderate cohort 67% had glucose taken, 45.9% had TFTs and 43.5% serum osmolality. Rise in sodium in 24 hrs ranged from 1 to 14 mmol with a mean of 4.7 mmol/L. In the mild cohort 66.7% had glucose taken, 27.4% had TFTs and 35.5% had serum osmolality. Rise in sodium in 24 hrs ranged from 1 to 16 mmol with a mean of 4.1 mmol/L. This study shows the current poor management of severely hyponatremic patients in our medical and surgical wards. There is a definite need to set up local guidelines for the management of such a common electrolyte abnormality. VL - 5 IS - 5 ER -
Information
Email: