Impaired hydration status in acutely admitted older patients: prevalence and impact on mortality.
Background impaired hydration is common in the older people, however studies of its effects on outcome in the acute setting are limited. Objectives to assess (i) the prevalence of impaired hydration, (ii) its relationship with laboratory markers of altered hydration and with (iii) short- and long-te...
| Published in: | Age & Ageing Vol. 50; no. 4; pp. 1151 - 1159 |
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| Main Authors: | , , , , , |
| Format: | Article |
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Oxford University Press / USA
Jul2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=151354041&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 151354041 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jul2021 vid: 50 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 151354041 10.1093/ageing/afaa264 ppf: 1151 ppct: 8 formats: tig: atl: Impaired hydration status in acutely admitted older patients: prevalence and impact on mortality. aug: au: Sanson, Gianfranco Marzinotto, Ilaria Matteis, Daniela De Boscutti, Giuliano Barazzoni, Rocco Zanetti, Michela affil: Clinical Department of Medical , Surgical and Health Sciences, University of Trieste , Trieste, 34149 Italy Internal Medicine Department , University Hospital , Trieste, 34149 Italy Nephrology and Dialysis Department , University Hospital , Udine, 33100 Italy su: Italy Retrospective studies Old age Hydration Biomarkers Glomerular filtration rate Hematocrit Urea Specific gravity Sodium Multivariate analysis Functional status Water-electrolyte imbalances Hospital mortality Disease prevalence Dehydration Osmolar concentration Longitudinal method Creatinine sug: subj: Retrospective studies Old age Italy Chemical fertilizer (except potash) manufacturing Hydration Biomarkers Glomerular filtration rate Hematocrit Urea Specific gravity Sodium Multivariate analysis Functional status Water-electrolyte imbalances Hospital mortality Disease prevalence Dehydration Osmolar concentration Longitudinal method Creatinine keyword: hospital hydration mortality older people serum osmolarity hospital hydration mortality older people serum osmolarity ab: Background impaired hydration is common in the older people, however studies of its effects on outcome in the acute setting are limited. Objectives to assess (i) the prevalence of impaired hydration, (ii) its relationship with laboratory markers of altered hydration and with (iii) short- and long-term mortality. Design retrospective cohort study. Setting University Hospital-Internal Medicine Department. Subjects a total of 5,113 older patients consecutively acutely admitted from October 2015 to July 2016. Methods according to calculated serum osmolarity at admission hydration status was stratified in: low osmolarity (<275 mmol/L), euhydration (275–295 mmol/L), impending (296–300 mmol/L) and current dehydration (>300 mmol/L). Relationships with serum sodium, potassium, glucose, urea, estimated glomerular filtration rate (eGFR), haematocrit, urea/creatinine ratio (Urea/Cr) and urine specific gravity (USG) were determined. Charlson Comorbidity Index, Modified Early Warning Score, Glasgow Prognostic Score, Norton score and Nutritional Risk Screening-2002 were calculated. Results current and impending dehydration, euhydration and low-osmolarity were detected in 51.7, 17.1, 28.5 and 2.7% of the patients, respectively. Osmolarity correlated with urea (r = 0.846). Associations with serum sodium, creatinine, eGFR and urea/Cr were low but significant, being negligible that with USG and haematocrit. Serum sodium and urea increased in the transition from low- to high-osmolarity (P < 0.001 in all pairwise comparisons). In multivariate modelling current dehydration, functional dependence, clinical instability and high nutritional risk were associated (P < 0.001) with reduced short- and long-term survival. Conclusions impaired hydration is common in older people acutely admitted to medical care and is associated with poor outcome. Early assessment of calculated serum osmolarity is mandatory to target dehydration and hypoosmolar disorders. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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