ECEESPE2025 Poster Presentations MTEabolism, Nutrition and Obesity (125 abstracts)
Management and diagnosis of moderate and severe hypernatraemia in a UK district hospital: a retrospective audit
Samraiz Nafees 1 , Muhammad Haroon Riasat 1 , Khaled Zamari 2 , Shahzad Akbar 3 , Ali Javeed 1 , Adi Ahmed 1 , Sarath Vayolipoyil 1 , Khush Bakht 1 , Muhammad Adnan Afzal 3 , Arshad Jamil 4 & Ali Hassan 5
1York and Scarborough Teaching Hospitals NHS Trust, Scarborough, United Kingdom; 2Gloucestershire Hospitals NHS Foundation Trust, Gloucester, United Kingdom; 3Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom; 4Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom; 5Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Background: Hypernatraemia, defined as serum sodium levels exceeding 145 mmol/l, affects 2.5% of inpatients in the United Kingdom. It is particularly prevalent among elderly patients with cognitive impairment and impaired thirst mechanisms, with mortality rates reaching 80% in this population. Our trust has implemented a hypernatraemia protocol to guide appropriate management, including recommended investigations and treatment modalities.
Objective: To assess compliance with the management protocol for patients with moderate to severe hypernatraemia (sodium levels >150 mmol/l) in our trust.
Methods: We conducted a retrospective audit of patients with serum sodium levels exceeding 150 mmol/l. Data collected included patient demographics, clinical presentations, investigations performed, and treatment duration.
Results: 43 patients met the inclusion criteria. The majority (85%) were over 75 years old, with 44% being nursing home residents and 30% having underlying neurological conditions. Common presenting symptoms included confusion (74%) and decreased levels of consciousness (47%). Clinical dehydration was observed in 60% of patients, establishing a causal relationship with severe hypernatraemia. Notably, 58% of patients had clinically stable NEWS scores of 1-3, indicating that severe hypernatraemia can occur in apparently well patients. The audit revealed suboptimal compliance with required investigations, with only a small number of patients undergoing urine osmolality, urinary sodium, and plasma osmolality tests. Treatment duration was prolonged, with 95% of patients requiring more than 48 hours for hypernatraemia correction, and 79% needing over 7 days.
Conclusions: Hypernatraemia remains a significant issue, particularly among elderly and cognitively impaired patients. Our findings highlight the need for improved adherence to local hypernatraemia guidelines. We recommend implementing regular monitoring and assessment of fluid status and sodium levels, as well as increasing awareness of the existing protocols among healthcare staff.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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