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Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators?

Vivanti, Angela P., Harvey, Keren, Ash, Susan, & Battistutta, Diana (2008) Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Archives of Gerontology and Geriatrics, 47(3), pp. 340-355.

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Abstract

Due to an absence of published primary data, this study explores dehydration prevalence and the change in physiological parameters frequently used to assess dehydration (fluid deficit) in older hospitalized people, as no standard measurement method exists. This observational longitudinal cohort study recruited 43 people aged 60 years or over, voluntarily admitted to a tertiary teaching hospital's Geriatric and Rehabilitation Unit (GARU). Over 40 clinical, hematological and urinary biochemical parameters employed by medical officers during dehydration assessment, identified through literature, interviews and focus group were investigated. Short-term weight changes, intra- and inter-rater repeatability of dehydration assessments were completed to assess validation and precision of the clinician's clinical dehydration assessment. Systolic blood pressure drop on standing, sternal skin turgor, tongue dryness and body mass index (BMI) were associated with hydration status; demonstrated clinically meaningful differences between groups. BMI negatively confounded the association between dehydration and systolic blood pressure drop on standing. Physical, rather than biochemical, parameters more often identified mild dehydration. The findings challenge common expectations of hematological and physiological measurement changes occurring in older people clinically assessed as dehydrated and emphasize the need to adjust for potential confounders during exploration of the associations of clinical parameters with dehydration status.

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22 citations in Scopus
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20 citations in Web of Science®

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ID Code: 18820
Item Type: Journal Article
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Keywords: Dehydration of elderly patients, Clinical assessment of hypovolemia, Hospital dehydration prevalence, Adjusting for potential confounders, Fluid deficit
DOI: 10.1016/j.archger.2007.08.016
ISSN: 0167-4943
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Aged Health Care (111702)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Deposited On: 21 Apr 2009 10:13
Last Modified: 29 Feb 2012 23:39

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