Subrath Das1, Siba Prasad Dash2, Subhabrata Das3, Jyoti Ranjan Mohapatra4, Rama Narayan Sahu5
Disorders of sodium and water metabolism are common in hospitalised patients and are occasionally encountered in outpatients. Both hyponatraemia and hypernatraemia can cause substantial morbidity and mortality, and ironically, incorrect treatment can add to the problem. But hyponatraemia is the most commonly seen electrolyte abnormality in surgical wards. The symptoms of hyponatraemia vary from anorexia, headache, nausea, vomiting and lethargy to convulsion, coma and death. Treatment of hyponatraemia must be individualised considering the aetiology, rate of development, severity and clinical signs and symptoms.
1. The study was aimed to find the incidence of hyponatraemia in emergency surgical patients, to correlate the impact of hyponatraemia in morbidity and mortality.
2. To diagnose hyponatraemia in patients early and proper management to avoid the unwanted complication.
MATERIALS AND METHODS
The present study was carried out in 72 emergency surgical patients admitted to Department of General Surgery of M.K.C.G Medical College and Hospital, Berhampur, during the period from September 2013 to August 2015.
1. During the period of study, 16 cases (21.81%) were detected of hyponatraemia from 72 patients in their hospital stay.
2. 4 female (23.53%) patients developed hyponatraemia and 12 male (22.22%) patients developed hyponatraemia during their hospital stay.
3. Out of 72 cases, 10 cases (13.89%) developed hyponatraemia in preoperative period. 6 cases (8.33%) developed hyponatraemia in postoperative period.
4. 14 cases (87.5%) manifested with symptoms of altered mental status. 7 cases (43.7%) manifested with nausea and vomiting. 10 cases (62.5%) presented with headache. Only 3 cases (18.7%) had convulsion due to hyponatraemia.
5. In the age group 0-20, no cases of hyponatraemia was observed while in the older age group (60-80) we observed 5 cases (50%) out of 10. In the age group 40-60, (25.00%) and in the age group 20-40, (13.33%) of cases developed hyponatraemia in their hospital.
6. 6 cases (2 females and 4 males presented with mild hyponatraemia (37.50%). 4 cases (1 female and 3 males) presented with moderate hyponatraemia (25.00%) and 6 cases (1 female and 5 males) found to have severe hyponatraemia out of total 16 cases (37.50%).
7. Out of 16 cases, 11 cases were grouped into hypovolaemic hyponatraemia and 5 cases into euvolaemic hyponatraemia according to their extracellular volume status.