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首页> 外文期刊>Aging clinical and experimental research >A comparative study of the syndrome of inappropriate antidiuretic hormone secretion in community-dwelling patients and nursing home residents.
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A comparative study of the syndrome of inappropriate antidiuretic hormone secretion in community-dwelling patients and nursing home residents.

机译：社区患者和疗养院居民抗利尿激素分泌不当综合征的比较研究。

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BACKGROUND AND AIMS: Limited data exist about the clinical characteristics of the syndrome of inappropriate antidiuretic hormone secretion (SIADHS) in hospitalized elderly. Moreover, there may be differences regarding this syndrome between populations, depending on the referral source to hospitals. The objectives of the study were to determine the etiology, clinical characteristics and hospital outcome in a sample of elderly hospitalized patients with SIADHS, and to compare community-dwelling patients (CDP) with nursing home residents (NHR). METHODS: This retrospective chart analysis was conducted in a university affiliated referral hospital. The participants were consecutive elderly patients, admitted with hyponatremia (< 135 mmol/L), and ultimately diagnosed as having SIADHS. We examined patient demographics, medical history, clinical presentation, laboratory and imaging studies, and hospital outcome. RESULTS: Of the 179 patients presenting with hyponatremia, 79 patients (44%) fulfilled the criteria for SIADHS; 73% of these patients were CDP and 27% were NHR (mean ages, 74.4 +/- 6.9 and 75.7 +/- 7.2 years, respectively). Most CDP complained of weakness and dizziness, while NHP presented with confusion, seizures and vomiting. Mean sodium levels and mean plasma osmolality values were similar in both groups, however, the number of patients with sodium levels < or = 121 mmol/L was significantly higher among NHR. The leading causes of SIADHS in both groups were medications, idiopathic form, and concurrent malignancies. In patients older than 81 years, idiopathic (50%) and drug-induced (20%) SIADHS were more frequent, compared with younger age groups. The overall in-hospital mortality rate was significantly higher in NHR as compared with CDP (p = 0.014), yet, it was similar in both groups once only patients with sodium levels of 121 mmo/L or lower were considered. CONCLUSIONS: While leading causes of SIADHS in community and nursing home residents are similar, there are marked differences in clinical presentation and outcome. This knowledge should help in identifying high-risk patients and taking appropriate measures.
机译：背景与目的：住院老年人抗利尿激素分泌不当综合征（SIADHS）的临床特征的数据有限。此外，根据医院的转诊来源，人群之间关于该综合征的可能有所不同。这项研究的目的是确定老年SIADHS住院患者的病因，临床特征和医院转归，并比较社区住院患者（CDP）和疗养院居民（NHR）。方法：该回顾性图表分析是在大学附属转诊医院进行的。参与者是连续的老年患者，入院时血钠不足（<135 mmol / L），并最终被诊断为患有SIADHS。我们检查了患者的人口统计学，病史，临床表现，实验室和影像学研究以及医院预后。结果：在179例低钠血症患者中，有79例（44％）符合SIADHS标准;这些患者中73％为CDP，27％为NHR（平均年龄分别为74.4 +/- 6.9岁和75.7 +/- 7.2岁）。大多数CDP抱怨虚弱和头晕，而NHP则感到困惑，癫痫发作和呕吐。两组的平均钠水平和平均血浆渗透压浓度相似，但是，在NHR中，钠水平≤121 mmol / L的患者人数明显更高。两组中SIADHS的主要原因是药物，特发性形式和并发恶性肿瘤。与年龄较小的年龄组相比，在81岁以上的患者中，特发性（50％）和药物引起的（20％）SIADHS更为频繁。与CDP相比，NHR的总体院内死亡率显着更高（p = 0.014），但是，仅考虑钠水平为121 mmo / L或更低的患者，两组的死亡率相似。结论：尽管社区和疗养院居民SIADHS的主要病因相似，但临床表现和结果存在明显差异。这些知识应有助于识别高危患者并采取适当措施。

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