Date of Award

Winter 4-1-2019

Document Type

Dissertation

Degree Name

PharmD

First Advisor

Dr. Girish Thunga

Second Advisor

Dr. Ravindra Munoli

Abstract

Abstract: Background: Prompt recognition and optimal management of hyponatremia will help the physician devise a better treatment plan to prevent future complications. Hence this study aims to identify of risk factors associated with hyponatremia in psychiatric patients.Methods: A case-control study was conducted among psychiatric inpatients in a tertiary care teaching hospital. Patients admitted from January 2013 to December 2017 were identified using ICD-10 code F01-F99. Patients with serum sodium levels <135 mmol/L were considered as hyponatremia and between 135-145 mmol/L as controls. Factors associated with causing hyponatremia were identified by multiple logistic regression and odds ratio (OR) was calculated.Results: Based on the inclusion and exclusion criteria, 264 cases of hyponatremia and 253 matching controls were included in the study. The mean age of patients with hyponatremia was 56.4±16.8 years as compared to 39.6±13.9 years in controls and 65.7% of them were males. Seizure disorder (OR=3.14, olar disorder (OR=6.03, p=0.001), depression (OR=4.78, p=0.005) and use of quetiapine (OR=2.11, p =0.007), insulin (OR=3.53, p=0.038) were independent risk factors associated with development of hyponatremia. Conclusion: Psychiatric patients with seizure disorder, bipolar disorder, depression and using quetiapine or insulin have more chance of developing hyponatremia. And they should be monitored carefully.

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