Impact of age on the seasonal prevalence of hypernatremia in the emergency department: A single-center study

Abstract

Background: Hypernatremia is one of the most commonly encountered electrolyte disorders in the emergency department (ED). Few studies have reported the seasonal fluctuations of the prevalence of hypernatremia with conflicting results. We investigated the seasonal prevalence of hypernatremia in an emergency department in Japan. Methods: A total of 12,598 patients presented to the ED between January 2015 and December 2017 were reviewed. The adult group aged between 18 and 64 years old consisted of 5427 patients and the elderly group aged over 65 years consisted of 7171 patients. Information collected included age, sex, serum sodium, and serum creatinine. Hypernatremia was defined as a serum sodium leve1 > 145 mEq/L, and moderate to severe hypernatremia was defined as a serum sodium level ≥ 150 mEq/L. Results: The prevalence of hypernatremia was significantly higher in the elderly group than in the adult group (2.6% vs. 0.7%; p < 0.001). Similarly, the prevalence of moderate to severe hypernatremia was significantly higher in the elderly group than in the adult group (1.0% vs. 0.1%; p < 0.001). The prevalence of hypernatremia and moderate to severe hypernatremia was significantly higher in the elderly group than in the adult group in all seasons. In the elderly group, the seasonal prevalence of moderate to severe hypernatremia was significantly higher during the winter. Also, there was a correlation between weather temperature and the prevalence of moderate to severe hypernatremia in the elderly group (r =-0.34, p = 0.04). Conclusions: Hypernatremia is prevalent in the elderly and the prevalence is highest during the winter. Special attention should be paid in the elderly patients to prevent hypernatremia especially in the winter.