The Causes Analysis Of Hyponatremia In Elderly Inpatients

Backgound:Hyponatremia is a metabolic imbalance of water and electrolyte caused by various causes,it occurs when lacking of sodium ions and(or)excessive water.In recent years,the incidence of hyponatremia increases year by year,the incidence of hyponatremia is higher in the elderly due to suffering from many kinds of basis diseases,taking a variety of drugs,poor adjustment ability and long-term inadequate intake of sodium salts.Hyponatremia is a negative predictor for many diseases,so it is necessary to improve recognition of hyponatremia for clinicians.Objective:We aimed to analyze types and percentages of the primary diseases in different degrees hyponatremia(mild,moderate,and severe)in the elderly,to analyze types and percentages of the primary diseases in SIADH,to explore the causes of higher incidence of idiopathic SIADH in the elderly.Methods:1.Study population:There were 319 hyponatremia inpatients in Shandong Province Hospital affiliated to Shandong University between May 2016 and May 2017,including 207 inpatients of aged?60 years.2.Study methods:According to the serum sodium concentration,We divided 207 patients into three groups:mild,moderate and severe,collecting general information(age,gender,length of hospital stay,department),medical history(current medical history and past medical history),laboratory examinations,imageological examinations,prognosis.3.Data analysis and statistical methods:Analyzing data by SPSS 20.0 program,the measurement data of normal distribution were compared by variance analysis,the measurement data of non-normal distribution were compared by Kruskal-Wallis Test,enumeration data were compared by ?2 test.If P<0.05,data tests were considered significant.Results:1.There were 319 hyponatremia inpatients,including 207 elderly patients aged?60 years,the incidence of hyponatremia was 64.89%in the elderly.The was no significant difference in gender,age,length of hospital stay,total protein,albumin,blood glucose,creatinine,hematocrit between three groups.2.The most common clinical departments were in turn pneumology department,endocrinology department,emergency department and neurology.3.The common causes of hyponatremia were infectious diseases,malignant tumors,reduced intake;the common causes of mild hyponatremia were infectious diseases,central nervous system diseases,reduced intake;the common causes of moderate hyponatremia were malignant tumors,heart failure and cirrhosis;the common causes of severe hyponatremia were malignant tumors,infectious diseases.4.There were 33 SIADH inpatients,the incidence of SIADH was 15.94%,there were 12 idiopathic SIADH inpatients,accounting for 36.36%;there were 10 malignant tumors inpatients,accounting for 30.30%;there were 6 pulmonary infection inpatients,accounting for 18.18%;there were 3 central nervous system diseases inpatients,accounted for 9.09%;there were 2 connective tissue diseases inpatients,accounting for 6.06%.Conclusion and significance:1.The incidence of hyponatremia in the elderly is high than the general population,the statistics show that the elderly hyponatremia inpatients accounted for 64.89%of hyponatremia inpatients;2.The types of cause were different in different degrees hyponatremia,the most common cause of mild hyponatremia was infectious diseases,the most common cause of moderate hyponatremia was malignant tumors,the most common cause of severe hyponatremia was malignant tumors;3.The common causes of SIADH in the elderly were idiopathic,malignant tumors,and infectious diseases.The incidence of idiopathic SIADH in the elderly was the highest,which may be related to disturbances in the internal environment in the elderly,but its specific pathogenesis still needs further study.