A Study of Clinical Profile and Management of Hypo/Hypernatremia in Patients Presenting to the Emergency Room with Altered Mental Status

Abstract

Background: Electrolyte disturbances, particularly hypo- and hypernatremia, are common causes of altered mental status (AMS) in emergency patients. These conditions, if not rapidly diagnosed and corrected, may lead to serious complications including cerebral edema, seizures, and death.
Objective: To assess the clinical presentation, sodium levels, management approaches, and outcomes of patients presenting with AMS due to hypo- or hypernatremia in a tertiary care emergency department.
Methods: A prospective observational study was conducted in a tertiary care hospital emergency room. One hundred and fifty patients presenting with AMS were enrolled. Serum sodium levels were measured at presentation and patients were categorized into hyponatremia (<135 mEq/L), hypernatremia (>145 mEq/L), or normonatremia (135–145 mEq/L). Clinical profiles, etiology, management, and outcomes were analyzed.
Results: Among 150 patients, 68 (45.3%) had hyponatremia, 42 (28%) had hypernatremia, and 40 (26.7%) were normonatremic. Common symptoms included confusion (82.6%), lethargy (65.3%), and seizures (18.6%). Hypovolemia was the most frequent etiology in hyponatremic patients, whereas dehydration and sepsis were predominant in hypernatremia. Mortality was higher in hypernatremic patients (19%) compared to hyponatremic (11.8%) and normonatremic patients (5%).
Conclusion: Sodium imbalances are significant contributors to AMS. Early detection and targeted correction of serum sodium levels can reduce complications and improve patient outcomes in the emergency setting.