Accuracy of the calculated serum osmolarity to screen for hyperosmolar dehydration in older hospitalised medical patients
| Autor: | Camilla Balle Bech, Tina Munk, A.W. Knudsen, Charlotte Suetta, Finn Rønholt, Tobias Wirenfeldt Klausen |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Hyperosmolar dehydration Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism 03 medical and health sciences fluids and secretions 0302 clinical medicine Internal medicine medicine Humans Reference standards Aged Osmole Geriatrics 030109 nutrition & dietetics Nutrition and Dietetics Dehydration business.industry Diagnostic Tests Routine Osmolar Concentration Sodium Infant Newborn Medical department Clinical Practice Serum osmolarity Serum osmolality Fluid Therapy Female business |
| Zdroj: | Clinical nutrition ESPEN. 43 |
| ISSN: | 2405-4577 |
| Popis: | Simple hyperosmolar dehydration, also termed water-loss dehydration (HD), is common in older hospitalised patients, thus increasing the risk of morbidity and mortality. Directly measured serum osmolality is the reference standard to determine HD; however, it is not a routine test due to its complexity and cost. Thus, a simple valid objective diagnostic tool to detect HD is needed. Consequently, we aimed to validate the agreement between measured s-osmolality (mOsm/kg) and calculated s-osmolarity (mOsm/L).Patients aged65 were included from the emergency medical department at Herlev Hospital, Copenhagen, Denmark. Exclusion criteria were: eGFR30 mmol/L, severe heart failure, decompensated cirrhosis, alcohol intake or initiated rehydration treatment. We obtained data for measured s-osmolality as well as calculated osmolarity, using the by ESPEN recommended equation [1.86x (NaA total of 90 patients (female 53%), age median 78 yrs (72-86 yrs) were included. According to the measured mOsm/kg, impending HD was evident in 32% (n = 10), of these 11% (n = 10) had current HD. There was a significant association between calculated mOsm/L and measured Osm/kg (rThe equation recommended by ESPEN to calculate osmolarity was found to be an accurate objective diagnostic tool to assess HD in older hospitalised medical patients. The method is markedly superior to the current clinical practice. |
| Databáze: | OpenAIRE |
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