Apparent Idiopathic Hyponatremia in an Ambulatory Geriatric Population

Miller, Myron; Hecker, Melanie S.; Friedlander, Deborah A.; Carter, John M.

doi:10.1111/j.1532-5415.1996.tb06410.x

Cited by 115 publications

(70 citation statements)

References 20 publications

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“…One potential explanation for our findings is that in everyday clinical practice, hyponatremia is difficult to diagnose by means of physical examination and is not always considered [23]. Another possible explanation is that sodium laboratory tests were routinely recorded in a selected patient population with other severe comorbidities.…”

Section: Discussionmentioning

confidence: 86%

Validity of hospital discharge International Classification of Diseases (ICD) codes for identifying patients with hyponatremia

Movig

Leufkens

Lenderink

et al. 2003

Journal of Clinical Epidemiology

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Medical diagnosis can be studied using various sources of information, such as medical and hospital discharge records and laboratory measurements. These sources do not always concur. The objective of the present study was to assess the sensitivity, specificity, and positive and negative predictive values of hospital discharge diagnosis compared with clinical laboratory data for the identification of hyponatremia. Patients with hyponatremia were selected from a hospital information system determined by the International Classification of Diseases, 9th edition (ICD-9). The validity parameters for hyponatremia (ICD code 276.1) were estimated by comparison with accurate serum sodium (Na ϩ ) levels. A total of 2632 cases of hyponatremia were identified using laboratory measurements (Na ϩ р 135 mmol/L). The sensitivity of ICD coding for hyponatremia was maximally about 30% for patients with very severe hyponatremia (Na ϩ р 115 mmol/L). Corresponding specificities were high (Ͼ 99%). In 87% of the cases with severe hyponatremia (Na ϩ р 125 mmol/L), other discharge ICD codes reflecting severe morbidity were found. This study suggests that ICD codes for hyponatremia represent only one third of the patients admitted to the hospital and experiencing hyponatremia. About two thirds of the patients with hyponatremia were classified as hospitalized for other reasons. To assess the validity of case finding of patients with hyponatremia, the use of analytical techniques, such as certain laboratory measurements, is advisable. Ć

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Section: Discussionmentioning

confidence: 86%

Validity of hospital discharge International Classification of Diseases (ICD) codes for identifying patients with hyponatremia

Movig

Leufkens

Lenderink

et al. 2003

Journal of Clinical Epidemiology

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“…Effective treatment and preventative strategies for recurrent falls remains highly limited (12). Mild chronic hyponatremia is a common electrolyte imbalance with a reported prevalence of 2% to 4% in the general population, rising to 7% to 11% in the ambulatory elderly (13,14) and to 42% in hospitalized subjects (14). The potential importance of the association of mild hyponatremia with fracture relates to this high prevalence of the condition, especially in groups that have a high risk of fracture after falls, such as the elderly.…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia Independent of Osteoporosis is Associated with Fracture Occurrence

Kinsella

Moran²,

Sullivan³

et al. 2010

Clinical Journal of the American Society of Nephrology

256

190

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“…Miller et al 6 report the findings of a large study of apparent idiopathic hyponatraemia in an ambulatory geriatric population which supports the hypothesis that aging is a risk factor for the development of an SIADH-like hyponatraemia in some older patients who do not have any other apparent underlying aetiology. The elderly patient described here had a pre operative serum sodium concentration at the lower end of the normal range (136 mmol-L-1).…”

Section: Discussionmentioning

confidence: 55%

SIADH following laparoscopic cholecystectomy

Cornforth

1998

Can J Anaesth

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Clinical Report SIADH following laparoscopic cholecystectomyPurpose: To present an unusual case of inappropriate antidiuretic hormone secretion syndrome a~er a minor surgical procedure in a healthy patient.Clinical features: A 71-yr-old woman underwent uneventful laparoscopic cholecystectomy for gallstones under general anaesthesia. Fifty-two hours post operatively she began convulsing and was found to have a serum sodium concentration as low as I 12 mmol'L -~. Serum osmolality, urinary sodium concentration and urine osmolality suggested a diagnosis of inappropriate antidiuretic hormone secretion. Subsequent treatment with anticonvulsants followed by strict fluid restriction which increased serum sodium concentrations led to rapid recovery. Conclusion:The syndrome of inappropriate ADH secretion has several well documented causes including major surgery. Few episodes have been described following minor surgery in healthy patients and the only possible risk factor evident in this patient could be her advancing years.Objectif : Rapporter un cas inusit~ de s~cr~tion inappropri~e d'hormone antidiur~tique (SIADH) apr~s une procedure chirurgicale mineure chez une patiente en bonne sant~.

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Apparent Idiopathic Hyponatremia in an Ambulatory Geriatric Population

Abstract: The results support the hypothesis that aging is a risk factor for the development of SIADH-like hyponatremia in a subset of older patients who do not have an apparent underlying etiology. Thus, aging may be an independent etiology for the development of hyponatremia.

Cited by 115 publications

References 20 publications

Validity of hospital discharge International Classification of Diseases (ICD) codes for identifying patients with hyponatremia

Validity of hospital discharge International Classification of Diseases (ICD) codes for identifying patients with hyponatremia

Hyponatremia Independent of Osteoporosis is Associated with Fracture Occurrence

SIADH following laparoscopic cholecystectomy

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