Hyponatremia in Patients Admitted with Stroke OC34-OC36
Dr. Thamarai Rajappa,
Associate Professor, Department of Biochemistry, Trichy SRM Medical College Hospital and Research Centre, Trichy, Irungalur-621105, Tamil Nadu, India.
Introduction: Many studies have focused on association of serum electrolytes with hypertension. In recent years status of serum sodium have established an important role in the distinguishing the two entities of hyponatremia in Cerebrovascular Accidents (CVA).
Aim: To estimate the serum sodium levels and to determine the incidence and aetiology of electrolyte disturbances in patients with newly diagnosed CVA.
Materials and Methods: This was the cross-sectional study conducted at the tertiary care teaching hospital, Trichy. 202 diagnosed stroke patients were evaluated for presence of hyponatremia. The data was analysed using independent t test using SPSS software 21.
Results: Among the 202 CVA patients, 78 patients (38.61%) presented with hyponatremia. Among the 78 patients, 43 (21.28%) were ascertained as Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH), in which ischemic stroke and haemorrhagic stroke were diagnosed in 31 and 12 patients respectively. Fifteen patients (7.42%) had Cerebral Salt Wasting Syndrome (CSWS), in which 5 patients had ischemic stroke and 10 patients had haemorrhagic stroke. A total of 20 (9.90%) cases had hyponatremia with unknown aetiology. The hospital stay of patients with hyponatremic CVA was more than patients with normal serum sodium level (mean 21 days).
Conclusion: This study shows that hyponatremia was observed in 38.61% of stroke patients. Among hyponatremia stroke cases, 21.28 % had SIADH and 7.42% had CSWS. The hospital stay of hyponatremic CVA patients was longer, hence monitoring of serum sodium is absolutely essential in patients admitted with stroke. Close observation and prompt diagnosis are needed to identify the cause of electrolyte disturbance, because their treatments are completely dissimilar.