A Study of the Management of Hyponatremia at Mater Dei Hospital, Malta
Issue:
Volume 5, Issue 5, September 2016
Pages:
41-45
Received:
11 August 2016
Accepted:
29 August 2016
Published:
15 October 2016
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.
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...
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