XXXX in a nursing home population.

@entity1 @entity6220 @entity602 @entity1372 @entity1011 @entity2753 @entity3488
OBJECTIVE: To determine the prevalence of @entity2753 in a nursing home population and to identify clinical factors that increase the risk for development of @entity2753 . DESIGN: Retrospective and prospective record review. SETTING: A Veterans Affairs nursing home care unit. @entity1 : One hundred nineteen residents, who ranged in age from 60 to 103 years. Sixty ambulatory @entity1 , 62 to 91 years of age, who attended a geriatric medicine outpatient clinic served as a reference population. MEASUREMENTS: Most recent serum @entity1372 , @entity1011 , BUN, and all serum @entity1372 determinations during the preceding 12 months; clinical diagnoses, diet, medications, and significant events at the time of recorded hyponatremic episodes; response to acute water loading in a subset of @entity1 ; number of deaths in the 12 months following entry into the study. RESULTS: In the 119 nursing home @entity1 , ages 60 years or older, the most recent serum @entity1372 identified 18% who were hyponatremic, compared with a prevalence of 8% in similarly aged ambulatory @entity1 . When all serum @entity1372 determinations for the previous 12 months were examined, 53% of the nursing home @entity1 had at least one episode of @entity2753 during this time period. There was a high incidence of central nervous system (CNS) and @entity602 in the total nursing home population. Episodes of @entity2753 were frequently associated with an increased intake of fluids, given either orally or intravenously, and with tube feeding. Water load testing revealed abnormal water handling consistent with the syndrome of inappropriate @entity3488 ( @entity3488 ) secretion in 18 of 23 @entity1 who had a history of @entity2753 . Seventeen percent of the @entity1 with @entity2753 died over the following 12 months, compared to a death rate of 21% in the normonatremic @entity1 . CONCLUSIONS: @entity2753 is a common occurrence in nursing home residents and may be a consequence of abnormal @entity3488 secretion resulting from @entity6220 . Exposure to increased fluid intake, or to a low @entity1372 tube-feeding diet, can lead to the onset of @entity2753 or to a worsening of an already present low-serum @entity1372 concentration.
