European Journal of Cardiovascular Medicine

Background: Elderly in-patients are most usually affected by hyponatremia, a relatively prevalent electrolyte problem in clinical medicine [1-3]. It is recognised as occurring in 15–30% of hospitalised patients and is indicated by an s. Na+ level of less than 135 mEq/L. However, it has been noted that the occurrence rate in older people might reach 50% [3-5]. OBJECTIVES:

1. To classify severity of hyponatremia in hospitalized elderly and to correlate with outcome following treatment.

2. To study clinical feature and etiology of hyponatremia in elderly hospitalized patients.

Material & Methods: Study Design:  Hospital based prospective observational study. Study area: Department of General Medicine, Subbaiah Institute of Medical Sciences, Shivamogga. Study Period:  July 2022 – June 2023. Study population: Elderly patients (60 yrs and older) admitted in medical ICU Sample size: Study consisted a total of 100 subjects. Sampling Technique:   Simple Random sampling. All elderly patients admitted to medical ICU, 3-5 ml of venous blood was collected in a yellow top vaccutainer, and 5-10ml of urine (spontaneous void or catheter specimen) is collected in clean bottle. Routine blood and urine investigations as appropriate the diagnosis like, Complete blood count, renal function tests, electrolytes, liver function tests, urine routine, chest radiograph and other imaging studies as needed are done. When the electrolytes reports are available, patients are enrolled in the study if they are having serum sodium less than 125mmol/L and the plasma and urine sample are sent for measurement of serum osmolality and urine osmolality by freezing point depression osmometer. Serum electrolytes and urine spot Sodium are measured by ion sensitive electrode method. Results: Among the 80 patients who improved 50 were female and 30 were male. And among the 20 patients, who expired, 15 were male and 5 were female. This indicates that among the 45 male patients admitted 30 (66.67%) patients improved and 15 (33.33%) patients expired, and among 55 female patients 50 (90.91%) improved and 5 (9.09%) expired. Which shows though the severe hyponatremia is high among females the response to treatment and survival is better among females than compared to males (p=0.0026). Conclusion: Clinicians need to be aware about the common occurrence of hyponatremia in acutely sick elderly and early identification and adherence to standardized correction protocol is essential to avoid complications and to reduce mortality. Meticulous monitoring for dosing of multiple drugs in elderly population would help in preventing hyponatremia.