Patients admitted to hospital from care homes are more likely to suffer from dehydration compared to those residing in their own homes, a recent study by Wolff et al (2015) found. Findings showed that older people living in care homes were 10 times more likely to suffer from hypernatraemia, or high plasma sodium, compared to those living in their own homes; 12 percent of care home patients had high plasma sodium from dehydration compared to only 1.3 percent of own-home patients.
The study involved patients 65 years or older with first admission to Barnet and Chase Farm Hospitals Trust between January 2011 and December 2013. The authors wanted to find out whether patients from care homes were more likely to exhibit hypernatraemia, which is indicative of dehydration. Researchers collected data on age, gender, type of admission, whether or not patients had dementia and whether they resided in a care home or their own home.
Laboratory data was used to identify dehydration upon admission, as well as whether they subsequently died in hospital. If patients had hypernatraemia in the first 24 hours of admission, they were considered to be dehydrated. In total, researchers looked at 21,610 admissions and identified 432 cases of high plasma sodium. There were a total of 1,413 hospital deaths recorded.
Although care home patients were older and more likely to have dementia compared to own-home patients, care home residents still had a five-fold increased risk of high sodium levels after adjusting for age, gender, admission type and presence of dementia. On its own, hypernatraemia was associated with a five-fold increased risk of dying in hospital.
Care home patients with dementia had the greatest risk of dehydration, followed by care home patients without dementia. Patients without dementia living in their own homes had the lowest risk of dehydration, followed by own-home patients with dementia. Addtionally, care home residents faced a two-fold increased risk of dying in hospital, adjusted figures showed. The authors concluded that the numbers of dehydrated care home patients admitted to hospital are too large, resulting in unnecessary loss of life.