Advanced age, altered level of consciousness and a new diagnosis of diabetes are independently associated with hypernatreamia in hyperglycaemic crisis

BMC Endocrine Disorders

Nomawethu T Tonjeni³  Anthonia O Ogbera²  Augustin Nge-Okwe¹  Benjamin Longo-Mbenza³  Chukwuma O Ekpebegh³ 

[1] Biostatistics Unit, Lomo Medical Center and Heart of Africa Centre of Cardiology, Kinshasa, Democratic Republic of Congo;Department of Internal Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria;Department of Internal Medicine, Faculty of Health Sciences, Walter Sisulu University/Nelson Mandela Academic Hospital, Mthatha, Eastern Cape Province, South Africa

关键词: South Africa;    determinants;    prevalence;    Hyperglyceamic crisis;    Hypernatreamia;   

Others  :  1086566
DOI  :  10.1186/1472-6823-11-8

 received in 2011-01-07, accepted in 2011-04-18,  发布年份 2011

【 摘 要 】

Background

There is limited literature on hypernatreamia in the setting of hyperglycaemic crisis. This is despite the fact that the presence of hypernatreamia may impact on the classification of hyperglycaemic crisis and its management particularly with regards to the nature of fluid therapy. We determined the prevalence of hypernatreamia and its associated factors at presentation for hyperglycaemic crisis.

Methods

This was a retrospective review of data for hyperglycaemic crisis admissions in Nelson Mandela Academic Hospital, Mthatha, South Africa. The prevalence of hypernatreamia (uncorrected Serum Sodium at presentation >145 mmol/L) was determined. Hyperosmolality was defined by calculated effective osmolality >320 mosmols/Kg. Multivariate logistic regression was undertaken using variables that were statistically significant in univariate analysis to ascertain those that were independently associated (Odds Ratio (OR) with 95% Confidence Interval (CI)) with hypernatreamia.

Results

The prevalence of hypernatreamia in our admissions for hyperglycaemic crisis was 11.7% (n = 32/273 including 171 females and 102 males). All admissions with hypernatreamia met the criteria for hyperosmolality. Age ≥ 60 years (OR = 3.9 95% CI 1.3-12.3; P = 0.018), Altered level of consciousness (OR = 8.8 95% CI 2.3-32.8; P < 0.001) and a new diagnosis of diabetes (OR = 3.7 95%CI 1.2-11.5; P = 0.025) were independently associated with hypernatreamia.

Conclusion

The prevalence rate of hypernatreamia in hyperglycaemic admissions was high with all hypernatreamic admissions meeting the criteria for hyperosmolality. Advanced age, altered conscious level and a new diagnosis of diabetes were independently associated with hypernatreamia.

【 授权许可】

   
2011 Ekpebegh et al; licensee BioMed Central Ltd.

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