Clinical Profile Of Hyponatremia In Adult Patients Admitted To Medical Intensive Care Unit Of A Tertiary Care Hospital

Abstract

Background and objectives Hyponatremia is the most common electrolyte disorder in critically ill patients and is a leading cause of morbidity and mortality. This study was done to evaluate the clinical features, etiology and severity of hyponatremia in critically ill patients admitted to Medical Intensive Care Unit. Methodology The present one year cross sectional observational study was done in the Department of Medicine of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. A total of 100 patients admitted in MICU with moderate to severe hyponatraemia from January 2014 to December 2014 were studied. Results The male to female ratio was 1.43:1 with 59% of the patients being males. Most of the patients were aged between 61 to 70 years (29%) and mean age was 58.94 ± 16.10 years. The commonest presentation was vomiting (28%) followed by confusion (26%). Nearly half of the study population had altered sensorium (48%). The commonest system to be involved was central nervous system (43%). On the basis of volume status, 50% of patients were euvolemic. 54% of the patients had severe hyponatraemia with confusion being significantly high in such patients (p<0.001). The commonest cause of hyponatremia was SIADH (46%) with infections (Tuberculosis, found in 57.7%) being the predominant cause. Majority (94%) of the patients in the study improved. There was positive association between SIADH and euvolemic hypoosmolar hyponatremia (p<0.001) and high urine sodium (p<0.001). Conclusion Clinicians need to be aware about the common occurrence of hyponatremia, its early identification and its association with large variety of diseases. Patients with hyponatraemia should be meticulously screened for the presence or absence of tuberculosis. A thorough understanding of the pathophysiological process of hyponatremia and its associated risk factor is of great important in prompt and effective treatment.