Undercorrection of hypernatremia is frequent and associated with mortality
Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We r...
Ausführliche Beschreibung
Autor*in: |
Bataille, Stanislas [verfasserIn] |
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E-Artikel |
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Englisch |
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2014 |
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Anmerkung: |
© Bataille et al.; licensee BioMed Central Ltd. 2014 |
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Übergeordnetes Werk: |
Enthalten in: BMC nephrology - London : BioMed Central, 2000, 15(2014), 1 vom: 21. Feb. |
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Übergeordnetes Werk: |
volume:15 ; year:2014 ; number:1 ; day:21 ; month:02 |
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DOI / URN: |
10.1186/1471-2369-15-37 |
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SPR027511561 |
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520 | |a Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. | ||
650 | 4 | |a Intracellular dehydration |7 (dpeaa)DE-He213 | |
650 | 4 | |a Dysnatremia |7 (dpeaa)DE-He213 | |
650 | 4 | |a Hypernatremia |7 (dpeaa)DE-He213 | |
650 | 4 | |a Renal failure |7 (dpeaa)DE-He213 | |
650 | 4 | |a Emergency |7 (dpeaa)DE-He213 | |
650 | 4 | |a Mortality |7 (dpeaa)DE-He213 | |
700 | 1 | |a Baralla, Camille |4 aut | |
700 | 1 | |a Torro, Dominique |4 aut | |
700 | 1 | |a Buffat, Christophe |4 aut | |
700 | 1 | |a Berland, Yvon |4 aut | |
700 | 1 | |a Alazia, Marc |4 aut | |
700 | 1 | |a Loundou, Anderson |4 aut | |
700 | 1 | |a Michelet, Pierre |4 aut | |
700 | 1 | |a Vacher-Coponat, Henri |4 aut | |
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10.1186/1471-2369-15-37 doi (DE-627)SPR027511561 (SPR)1471-2369-15-37-e DE-627 ger DE-627 rakwb eng Bataille, Stanislas verfasserin aut Undercorrection of hypernatremia is frequent and associated with mortality 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Bataille et al.; licensee BioMed Central Ltd. 2014 Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. Intracellular dehydration (dpeaa)DE-He213 Dysnatremia (dpeaa)DE-He213 Hypernatremia (dpeaa)DE-He213 Renal failure (dpeaa)DE-He213 Emergency (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Baralla, Camille aut Torro, Dominique aut Buffat, Christophe aut Berland, Yvon aut Alazia, Marc aut Loundou, Anderson aut Michelet, Pierre aut Vacher-Coponat, Henri aut Enthalten in BMC nephrology London : BioMed Central, 2000 15(2014), 1 vom: 21. Feb. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:15 year:2014 number:1 day:21 month:02 https://dx.doi.org/10.1186/1471-2369-15-37 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2014 1 21 02 |
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10.1186/1471-2369-15-37 doi (DE-627)SPR027511561 (SPR)1471-2369-15-37-e DE-627 ger DE-627 rakwb eng Bataille, Stanislas verfasserin aut Undercorrection of hypernatremia is frequent and associated with mortality 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Bataille et al.; licensee BioMed Central Ltd. 2014 Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. Intracellular dehydration (dpeaa)DE-He213 Dysnatremia (dpeaa)DE-He213 Hypernatremia (dpeaa)DE-He213 Renal failure (dpeaa)DE-He213 Emergency (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Baralla, Camille aut Torro, Dominique aut Buffat, Christophe aut Berland, Yvon aut Alazia, Marc aut Loundou, Anderson aut Michelet, Pierre aut Vacher-Coponat, Henri aut Enthalten in BMC nephrology London : BioMed Central, 2000 15(2014), 1 vom: 21. Feb. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:15 year:2014 number:1 day:21 month:02 https://dx.doi.org/10.1186/1471-2369-15-37 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2014 1 21 02 |
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10.1186/1471-2369-15-37 doi (DE-627)SPR027511561 (SPR)1471-2369-15-37-e DE-627 ger DE-627 rakwb eng Bataille, Stanislas verfasserin aut Undercorrection of hypernatremia is frequent and associated with mortality 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Bataille et al.; licensee BioMed Central Ltd. 2014 Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. Intracellular dehydration (dpeaa)DE-He213 Dysnatremia (dpeaa)DE-He213 Hypernatremia (dpeaa)DE-He213 Renal failure (dpeaa)DE-He213 Emergency (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Baralla, Camille aut Torro, Dominique aut Buffat, Christophe aut Berland, Yvon aut Alazia, Marc aut Loundou, Anderson aut Michelet, Pierre aut Vacher-Coponat, Henri aut Enthalten in BMC nephrology London : BioMed Central, 2000 15(2014), 1 vom: 21. Feb. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:15 year:2014 number:1 day:21 month:02 https://dx.doi.org/10.1186/1471-2369-15-37 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2014 1 21 02 |
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10.1186/1471-2369-15-37 doi (DE-627)SPR027511561 (SPR)1471-2369-15-37-e DE-627 ger DE-627 rakwb eng Bataille, Stanislas verfasserin aut Undercorrection of hypernatremia is frequent and associated with mortality 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Bataille et al.; licensee BioMed Central Ltd. 2014 Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. Intracellular dehydration (dpeaa)DE-He213 Dysnatremia (dpeaa)DE-He213 Hypernatremia (dpeaa)DE-He213 Renal failure (dpeaa)DE-He213 Emergency (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Baralla, Camille aut Torro, Dominique aut Buffat, Christophe aut Berland, Yvon aut Alazia, Marc aut Loundou, Anderson aut Michelet, Pierre aut Vacher-Coponat, Henri aut Enthalten in BMC nephrology London : BioMed Central, 2000 15(2014), 1 vom: 21. Feb. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:15 year:2014 number:1 day:21 month:02 https://dx.doi.org/10.1186/1471-2369-15-37 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2014 1 21 02 |
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10.1186/1471-2369-15-37 doi (DE-627)SPR027511561 (SPR)1471-2369-15-37-e DE-627 ger DE-627 rakwb eng Bataille, Stanislas verfasserin aut Undercorrection of hypernatremia is frequent and associated with mortality 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Bataille et al.; licensee BioMed Central Ltd. 2014 Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. Intracellular dehydration (dpeaa)DE-He213 Dysnatremia (dpeaa)DE-He213 Hypernatremia (dpeaa)DE-He213 Renal failure (dpeaa)DE-He213 Emergency (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Baralla, Camille aut Torro, Dominique aut Buffat, Christophe aut Berland, Yvon aut Alazia, Marc aut Loundou, Anderson aut Michelet, Pierre aut Vacher-Coponat, Henri aut Enthalten in BMC nephrology London : BioMed Central, 2000 15(2014), 1 vom: 21. Feb. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:15 year:2014 number:1 day:21 month:02 https://dx.doi.org/10.1186/1471-2369-15-37 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2014 1 21 02 |
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Enthalten in BMC nephrology 15(2014), 1 vom: 21. Feb. volume:15 year:2014 number:1 day:21 month:02 |
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Intracellular dehydration Dysnatremia Hypernatremia Renal failure Emergency Mortality |
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Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. 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Undercorrection of hypernatremia is frequent and associated with mortality |
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Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. © Bataille et al.; licensee BioMed Central Ltd. 2014 |
abstractGer |
Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. © Bataille et al.; licensee BioMed Central Ltd. 2014 |
abstract_unstemmed |
Background About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. Methods We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization. Results During 2010, 85 cases of severe hypernatremia ≥150 mmol/l were admitted to ED. Hypernatremia occurred in frail patients: mean age 79.7 years, 55% institutionalized, 28% with dementia. Twenty four percent of patients died during hospitalization. Male gender and low mean blood pressure (MBP) were independently associated with death, as well as slow natremia correction speed, but not the severity of hyperosmolarity at admission. Infusion solute was inappropriate for 45% of patients with MBP <70 mmHg who received hypotonic solutes and 22% of patients with MBP ≥70 mmHg who received isotonic solutes or were not perfused. Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. Medical management of hypernatremic patients must be improved regarding evaluation and treatment. © Bataille et al.; licensee BioMed Central Ltd. 2014 |
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Conclusions This is the first study assessing outcome of hypernatremic patients in the ED according to the treatment provided. It appears that not only a too quick, but also a too slow correction speed is associated with an increased risk of death regardless of initial natremia. 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