Physical Signs of Dehydration in the Elderly

  • Shimizu Miyuki
    Terumo Corporation R&D Headquarters, Japan
  • Kinoshita Kensuke
    Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
  • Hattori Kazuya
    Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
  • Ota Yoshio
    Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
  • Kanai Takao
    Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
  • Kobayashi Hiroyuki
    Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
  • Tokuda Yasuharu
    Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan

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Objective Dehydration is a common condition and frequent cause of hospitalization in older people, despite the caregiver's high attention in attempt to avoid its occurrence. In this study, various physical signs were examined as clinical signs of dehydration in elderly.<br> Methods A prospective observational study was conducted in an acute care teaching hospital. Consecutive elderly patients who were admitted to the Department of Medicine were evaluated. Dehydration was defined as a calculated serum osmolality above 295 mOsm/L. The patients diagnosed as dehydrated or not dehydrated were observed for physical signs of dehydration. Data of blood and urine chemistry analysis were also compared between the two groups.<br> Results A total of 27 elderly patients admitted with acute medical conditions were included in this study. For the physical signs, dry axilla had moderate sensitivity (44%) and excellent specificity (89%) to detect dehydration. Sunken eyes and delayed capillary refill time also showed relatively good specificity (83%). For laboratory data, the mean concentrations of serum sodium of the dehydrated group (146 mEq/L) was significantly higher (p<0.01) than those of the non-dehydrated group (134 mEq/L).<br> Conclusion Physical signs of dehydration in elderly showed relatively good specificity but poor sensitivity. The evaluation of the axillary moisture could help assess dehydration as well as laboratory data analysis such as serum sodium concentration.<br>

収録刊行物

  • Internal Medicine

    Internal Medicine 51 (10), 1207-1210, 2012

    一般社団法人 日本内科学会

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