NDLI: Serum sodium abnormalities during nonexertional heatstroke: incidence and prognostic values.

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Serum sodium abnormalities during nonexertional heatstroke: incidence and prognostic values.

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Serum sodium abnormalities during nonexertional heatstroke: incidence and prognostic values.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hausfater, Pierre Mégarbane, Bruno Fabricatore, Laurent Dautheville, Sandrine Patzak, Anabela Andronikof, Marc Santin, Aline Kierzek, Gérald Doumenc, Benoît Leroy, Christophe Manamani, Jafar Peviriéri, Florence Riou, Bruno
Description	Author Affiliation: Hausfater P ( Emergency Department, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris, Paris, and UPMC Univ Paris 06 France. pierre.hausfater@psl.aphp.fr)
Abstract	BACKGROUND: Although heatstroke is often associated with dehydration, the clinical significance of serum sodium abnormalities in patients with heat-related illness during heat wave has been poorly documented. METHOD: We evaluated 1263 patients (age, 82±15 years; body temperature, 40.1°C+1.2°C) admitted to emergency departments during the August 2003 heat wave in Paris, having a core temperature greater than 38.5°C and measurement of serum sodium concentrations. Patients were classified according to our previously described risk score of death. RESULTS: Hyponatremia (<135 mmol/L) was reported in 409 (32%) and hypernatremia (>145 mmol/L) in 220 patients (17%). One-year survival was significantly decreased in patients with hypernatremia (45%; P=.004) but not in those with hyponatremia (58%; P=.86) as compared with patients with serum sodium concentration in the reference range (57%). Using Cox regression, only hypernatremia was an independent prognostic factor (hazard ratio, 1.35; 95% confidence interval, 1.09-1.36) when risk score was taken into account. Using logistic regression, 2 variables were independently associated with hyponatremia (heatstroke severity score and blood urea nitrogen-creatinine ratio<100). Conversely, 5 variables were independently associated with hypernatremia (living in an institution, dementia, serum creatinine>120 µmol/L, a blood urea nitrogen-creatinine ratio >100, and absence of long-term diuretic intake). CONCLUSIONS: Serum sodium abnormalities are frequently observed in patients with a nonexertional heatstroke during heat wave; however, only hypernatremia should be considered as an independent risk factor of death. Rapid measurement of serum sodium concentration is mandatory to appropriately guide electrolyte resuscitation.
File Format	HTM / HTML
ISSN	07356757
Issue Number	5
Volume Number	30
e-ISSN	15328171
Journal	The American Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2012-06-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Discipline Medicine Heat Stroke Blood Sodium Age Factors Aged Aged, 80 And Over Emergency Service, Hospital Statistics & Numerical Data Female Diagnosis Mortality Physiopathology Humans Hypernatremia Complications Hyponatremia Incidence Kaplan-meier Estimate Male Middle Aged Prognosis Proportional Hazards Models Risk Factors Physiology Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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