{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T01:10:14Z","timestamp":1784164214745,"version":"3.55.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Geriatr Med"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Purpose<\/jats:title>\n<jats:p>This study aimed to explore the incidence, clinical features, etiology, and mortality of hyponatremia in older inpatients and thus provide preliminary data for an epidemiological study.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Hospitalized older patients diagnosed with hyponatremia at the First Medical Center of PLA General Hospital during January 2013\u2013December 2016 were stratified by serum sodium concentrations into mild (130\u2013\u2009&lt;\u2009135\u00a0mmol\/L), moderate (125\u2013\u2009&lt;\u2009130\u00a0mmol\/L) and severe hyponatremia groups (&lt;\u2009125\u00a0mmol\/L). Etiologies, medication histories, hospitalization times, and outcomes were analyzed.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>During the indicated period, 4364 older patients with hyponatremia were hospitalized, including 2934 men and 1430 women with an average age of 84.6\u2009\u00b1\u20093.5\u00a0years (range 80\u2013104\u00a0years). The prevalence of hyponatremia was 24.7%. An analysis of common primary diseases identified respiratory diseases as the most frequent (25.0%), followed by tumors (23.1%), cardiovascular diseases (19.9%), central nervous system diseases (8.9%), and orthopedic diseases (6.1%). PPIs (59.7%), loop diuretics (57.4%), potassium-preserving diuretics (29.5%), ACEIs\/ARBs (20.0%), thiazide diuretics (12.5%), and NSAIDs (12.4%) were the drugs most commonly associated with hyponatremia. The in-hospital mortality rate was 11.7%. Aggravated hyponatremia led to a prolonged hospitalization time. Moreover, when compared with mild hyponatremia, moderate and severe hyponatremia were associated with significant increases in in-hospital mortality (ORs 1.89 and 2.66, respectively; 95% CIs 1.54\u20132.33 and 2.06\u20133.43, respectively; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Hyponatremia is a common complication in hospitalized older patients and is caused mainly by respiratory diseases, tumors, and cardiovascular diseases. Given the correlation between the degree of hyponatremia and prognosis, the early and accurate identification and treatment of this condition can reduce the associated morbidity and mortality.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s41999-020-00320-3","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T19:02:59Z","timestamp":1588705379000},"page":"685-692","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Prevalence of hyponatremia among older inpatients in a general hospital"],"prefix":"10.1007","volume":"11","author":[{"given":"Xu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Ying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,5]]},"reference":[{"key":"320_CR1","doi-asserted-by":"publisher","first-page":"e0194379","DOI":"10.1371\/journal.pone.0194379","volume":"13","author":"S Al Mawed","year":"2018","unstructured":"Al Mawed S, Pankratz VS, Chong K et al (2018) Low serum sodium levels at hospital admission: outcomes among 2.3 million hospitalized patients. PLoS One 13:e0194379","journal-title":"PLoS One"},{"key":"320_CR2","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1186\/s12882-016-0370-z","volume":"17","author":"T Krummel","year":"2016","unstructured":"Krummel T, Prinz E, Metten MA et al (2016) Prognosis of patients with severe hyponatraemia is related not only to hyponatraemia but also to comorbidities and to medical management: results of an observational retrospective study. BMC Nephrol 17:159","journal-title":"BMC Nephrol"},{"key":"320_CR3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.ejca.2018.08.019","volume":"104","author":"AH Ingles Garces","year":"2018","unstructured":"Ingles Garces AH, Ang JE, Ameratunga M et al (2018) A study of 1088 consecutive cases of electrolyte abnormalities in oncology phase I trials. Eur J Cancer 104:32\u201338","journal-title":"Eur J Cancer"},{"key":"320_CR4","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1186\/s12882-017-0744-x","volume":"18","author":"J Hao","year":"2017","unstructured":"Hao J, Li Y, Zhang X et al (2017) The prevalence and mortality of hyponatremia is seriously underestimated in Chinese general medical patients: an observational retrospective study. BMC Nephrol 18:328","journal-title":"BMC Nephrol"},{"key":"320_CR5","doi-asserted-by":"publisher","first-page":"S30","DOI":"10.1016\/j.amjmed.2006.05.005","volume":"119","author":"A Upadhyay","year":"2006","unstructured":"Upadhyay A, Jaber BL, Madias NE (2006) Incidence and prevalence of hyponatremia. Am J Med 119:S30\u2013S35","journal-title":"Am J Med"},{"key":"320_CR6","first-page":"175","volume":"13","author":"G Liamis","year":"2016","unstructured":"Liamis G, Filippatos TD, Elisaf MS (2016) Thiazide-associated hyponatremia in the elderly: what the clinician needs to know. J Geriatr Cardiol 13:175\u2013182","journal-title":"J Geriatr Cardiol"},{"key":"320_CR7","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1159\/000360134","volume":"60","author":"G Lindner","year":"2014","unstructured":"Lindner G, Pfortmuller CA, Leichtle AB et al (2014) Age-related variety in electrolyte levels and prevalence of dysnatremias and dyskalemias in patients presenting to the emergency department. Gerontology 60:420\u2013423","journal-title":"Gerontology"},{"key":"320_CR8","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1177\/2042098610394233","volume":"2","author":"RL Soiza","year":"2011","unstructured":"Soiza RL, Talbot HS (2011) Management of hyponatraemia in older people: old threats and new opportunitie. Ther Adv Drug Saf 2:9\u201317","journal-title":"Ther Adv Drug Saf"},{"key":"320_CR9","doi-asserted-by":"publisher","first-page":"366","DOI":"10.2215\/CJN.07400717","volume":"13","author":"KL Nowak","year":"2018","unstructured":"Nowak KL, Yaffe K, Orwoll ES et al (2018) Serum sodium and cognition in older community-dwelling men. Clin J Am Soc Nephrol 13:366\u2013374","journal-title":"Clin J Am Soc Nephrol"},{"key":"320_CR10","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1186\/s12877-019-1282-0","volume":"19","author":"S Boyer","year":"2019","unstructured":"Boyer S, Gayot C, Bimou C et al (2019) Prevalence of mild hyponatremia and its association with falls in older adults admitted to an emergency geriatric medicine unit (the MUPA unit). BMC Geriatr 19:265","journal-title":"BMC Geriatr"},{"key":"320_CR11","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1111\/cen.13790","volume":"89","author":"G Corona","year":"2018","unstructured":"Corona G, Norello D, Parenti G et al (2018) Hyponatremia, falls and bone fractures: a systematic review and meta-analysis. Clin Endocrinol (Oxf) 89:505\u2013513","journal-title":"Clin Endocrinol (Oxf)"},{"key":"320_CR12","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1530\/EJE-16-0500","volume":"175","author":"B Winzeler","year":"2016","unstructured":"Winzeler B, Jeanloz N, Nigro N et al (2016) Long-term outcome of profound hyponatremia: a prospective 12 months follow-up study. Eur J Endocrinol 175:499\u2013507","journal-title":"Eur J Endocrinol"},{"key":"320_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000477675","volume":"71","author":"E Gomez-Hoyos","year":"2017","unstructured":"Gomez-Hoyos E, Cuesta M, Del Prado-Gonzalez N et al (2017) Prevalence of hyponatremia and its associated morbimortality in hospitalized patients receiving parenteral nutrition. Ann Nutr Metab 71:1\u20137","journal-title":"Ann Nutr Metab"},{"key":"320_CR14","doi-asserted-by":"publisher","first-page":"75","DOI":"10.5414\/CN108453","volume":"84","author":"A Ganguli","year":"2015","unstructured":"Ganguli A, Mascarenhas RC, Jamshed N et al (2015) Hyponatremia: incidence, risk factors, and consequences in the elderly in a home-based primary care program. Clin Nephrol 84:75\u201385","journal-title":"Clin Nephrol"},{"key":"320_CR15","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.amjmed.2013.07.006","volume":"126","author":"JG Verbalis","year":"2013","unstructured":"Verbalis JG, Goldsmith SR, Greenberg A et al (2013) Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med 126:S1\u2013S42","journal-title":"Am J Med"},{"key":"320_CR16","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1007\/s00345-016-1793-7","volume":"34","author":"DM Moreira","year":"2016","unstructured":"Moreira DM, Gershman B, Lohse CM et al (2016) Paraneoplastic syndromes are associated with adverse prognosis among patients with renal cell carcinoma undergoing nephrectomy. World J Urol 34:1465\u20131472","journal-title":"World J Urol"},{"key":"320_CR17","first-page":"w14662","volume":"148","author":"AE Althaus","year":"2018","unstructured":"Althaus AE, Krapf R (2018) Quality and cost considerations in hyponatraemic patients needing hospitalisation. Swiss Med Wkly 148:w14662","journal-title":"Swiss Med Wkly"},{"key":"320_CR18","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1016\/j.amjmed.2016.03.007","volume":"129","author":"G Corona","year":"2016","unstructured":"Corona G, Giuliani C, Parenti G et al (2016) The economic burden of hyponatremia: systematic review and meta-analysis. Am J Med 129:823\u2013835","journal-title":"Am J Med"},{"key":"320_CR19","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1071\/HC17084","volume":"10","author":"I Grattagliano","year":"2018","unstructured":"Grattagliano I, Mastronuzzi T, D'Ambrosio G (2018) Hyponatremia associated with long-term medication use in the elderly: an analysis in general practice. J Prim Health Care 10:167\u2013173","journal-title":"J Prim Health Care"},{"key":"320_CR20","first-page":"121","volume":"74","author":"CL Tay","year":"2019","unstructured":"Tay CL, Myint PK, Mohazmi M et al (2019) Prevalence and documented causes of hyponatraemia among geriatric patients attending a primary care clinic. Med J Malaysia 74:121\u2013127","journal-title":"Med J Malaysia"},{"key":"320_CR21","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1007\/s10157-018-1607-x","volume":"22","author":"T Naka","year":"2018","unstructured":"Naka T, Kohagura K, Kochi M et al (2018) Hyponatremia and mortality among very elderly residents in a geriatric health service facility. Clin Exp Nephrol 22:1404\u20131410","journal-title":"Clin Exp Nephrol"},{"key":"320_CR22","doi-asserted-by":"publisher","first-page":"988","DOI":"10.4103\/jfmpc.jfmpc_32_19","volume":"8","author":"AK Jain","year":"2019","unstructured":"Jain AK, Nandy P (2019) Clinico-etiological profile of hyponatremia among elderly age group patients in a tertiary care hospital in Sikkim. J Family Med Prim Care 8:988\u2013994","journal-title":"J Family Med Prim Care"},{"key":"320_CR23","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12873-018-0182-5","volume":"18","author":"N Lmai","year":"2018","unstructured":"Lmai N, Osako K, Kaneshiro N et al (2018) Seasonal prevalence of hyponatremia in the emergency department: impact of age. BMC Emerg Med 18:41\u201345","journal-title":"BMC Emerg Med"},{"key":"320_CR24","first-page":"158","volume":"43","author":"P Siregar","year":"2011","unstructured":"Siregar P (2011) The risk of hyponatremia in the elderly compared with younger in the hospital inpatient and outpatient. Acta Med Indones 43:158\u2013161","journal-title":"Acta Med Indones"},{"key":"320_CR25","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1093\/ndt\/gfi082","volume":"21","author":"EJ Hoorn","year":"2006","unstructured":"Hoorn EJ, Lindemans J, Zietse R (2006) Development of severe hyponatraemia in hospitalized patients: treatment-related risk factors and inadequate management. Nephrol Dial Transplant 21:70\u201376","journal-title":"Nephrol Dial Transplant"},{"key":"320_CR26","doi-asserted-by":"publisher","first-page":"67","DOI":"10.31729\/jnma.2821","volume":"54","author":"L Karki","year":"2016","unstructured":"Karki L, Thapa B, Sah MK (2016) Hyponatremia in patients with community acquired pneumonia. JNMA J Nepal Med Assoc 54:67\u201371","journal-title":"JNMA J Nepal Med Assoc"},{"key":"320_CR27","first-page":"e5673","volume":"11","author":"V Shah","year":"2019","unstructured":"Shah V, Jahan N (2019) Prognostic significance of hyponatremia in ST-elevation myocardial infarction\/heart failure patients. Cureus 11:e5673","journal-title":"Cureus"},{"key":"320_CR28","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1002\/cld.790","volume":"13","author":"B Attar","year":"2019","unstructured":"Attar B (2019) Approach to hyponatremia in cirrhosis. Clin Liver Dis (Hoboken) 13:98\u2013101","journal-title":"Clin Liver Dis (Hoboken)"},{"key":"320_CR29","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.1007\/s00520-014-2522-7","volume":"23","author":"J Yoon","year":"2015","unstructured":"Yoon J, Ahn SH, Lee YJ et al (2015) Hyponatremia as an independent prognostic factor in patients with terminal cancer. Support Care Cancer 23:1735\u20131740","journal-title":"Support Care Cancer"},{"key":"320_CR30","first-page":"1","volume":"20","author":"G Liamis","year":"2019","unstructured":"Liamis G, Barkas F, Megapanou E et al (2019) Hyponatremia in acute stroke patients: pathophysiology, clinical significance, and management options. Eur Neurol 20:1\u20139","journal-title":"Eur Neurol"},{"key":"320_CR31","doi-asserted-by":"publisher","first-page":"e14243","DOI":"10.1097\/MD.0000000000013389","volume":"97","author":"X Gang","year":"2018","unstructured":"Gang X, Zhang Y, Pan X et al (2018) Hyponatremia: prevalence and characteristics in internal medicine patients in southeast of China. Medicine (Baltimore) 97:e14243","journal-title":"Medicine (Baltimore)"},{"key":"320_CR32","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.2147\/CIA.S138535","volume":"12","author":"TD Filippatos","year":"2017","unstructured":"Filippatos TD, Makri A, Elisaf MS et al (2017) Hyponatremia in the elderly: challenges and solutions. Clin Interv Aging 12:1957\u20131965","journal-title":"Clin Interv Aging"},{"key":"320_CR33","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.semnephrol.2011.09.010","volume":"31","author":"JK Hix","year":"2011","unstructured":"Hix JK, Silver S, Sterns RH (2011) Diuretic-associated hyponatremia. Semin Nephrol 31:553\u2013566","journal-title":"Semin Nephrol"},{"key":"320_CR34","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1111\/j.1365-2125.2005.02531.x","volume":"61","author":"JA Clayton","year":"2006","unstructured":"Clayton JA, Rodgers S, Blakey J et al (2006) Thiazide diuretic prescription and electrolyte abnormalities in primary care. Br J Clin Pharmacol 61:87\u201395","journal-title":"Br J Clin Pharmacol"},{"key":"320_CR35","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1001\/archinternmed.2009.513","volume":"170","author":"R Wald","year":"2010","unstructured":"Wald R, Jaber BL, Price LL et al (2010) Impact of hospital-associated hyponatremia on selected outcomes. Arch Intern Med 170:294\u2013302","journal-title":"Arch Intern Med"},{"key":"320_CR36","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1111\/cen.12429","volume":"81","author":"P Tzoulis","year":"2014","unstructured":"Tzoulis P, Bagkeris E, Bouloux PM (2014) A case-control study of hyponatraemia as an independent risk factor for inpatient mortality. Clin Endocrinol (Oxf) 81:401\u2013407","journal-title":"Clin Endocrinol (Oxf)"},{"key":"320_CR37","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1530\/EJE-15-0111","volume":"173","author":"L Holland-Bill","year":"2015","unstructured":"Holland-Bill L, Christiansen CF, Heide-J\u00f8rgensen U et al (2015) Hyponatremia and mortality risk: a Danish cohort study of 279 508 acutely hospitalized patients. Eur J Endocrinol Eur Feder Endocrine Soc 173:71\u201381","journal-title":"Eur J Endocrinol Eur Feder Endocrine Soc"},{"key":"320_CR38","first-page":"29","volume":"59","author":"Y Zheng","year":"2020","unstructured":"Zheng Y, Zheng FP, Li H (2020) The prevalence and causes of hyponatremia in hospitalized patients. Zhonghua Nei Ke Za Zhi 59:29\u201334","journal-title":"Zhonghua Nei Ke Za Zhi"}],"container-title":["European Geriatric Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-020-00320-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41999-020-00320-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-020-00320-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T23:27:06Z","timestamp":1620170826000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s41999-020-00320-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,5]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["320"],"URL":"https:\/\/doi.org\/10.1007\/s41999-020-00320-3","relation":{},"ISSN":["1878-7657"],"issn-type":[{"value":"1878-7657","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,5]]},"assertion":[{"value":"17 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ethics committee of Medical School of Chinese PLA General Hospital)\u00a0and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All study participants provided informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}