时间标签：数据日期 2026-11-05 · 生成时间 2026-11-05 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/11/02 – 2026/11/06 ｜ 情报发生日期 2026-11-05
研究问题
The sample size calculation was performed for the primary objective of the original study and not for the present secondary analysis.Participants of this analysis were exclusively enrolled at Marien Hospital Herne (n = 455), because laboratory parameter were only available in these participants.；However, although the selected formula has been reported to show the best agreement with directly measured osmolality [13], it remains unclear whether it aligns well with the clinical diagnosis of dehydration.；However, according to the ESPEN guideline, interpreting a raised osmolarity as dehydration requires considering whether glucose (and to some extent urea) is within the normal range, because elevations in these osmotically active solutes can increase osmolarity independently of low-intake dehydration, an effect also reflected in our data.
方法
However, in older patients, clinical signs and symptoms are often non-specific, and there is no universally accepted single gold standard for diagnosing dehydration.；Serum osmolality can be measured directly using an osmometer (e.g., freezing-point depression), providing an estimate of the total concentration of osmotically active particles in serum/plasma [13].；The ESPEN guideline on clinical nutrition and hydration in geriatrics recommends that, when direct measurement is not available, osmolarity may be calculated from routinely measured osmotically active constituents (e.g., sodium, glucose, and urea) [11].
核心结论
This formula has demonstrated best overall agreement with directly measured osmolality [13].Patients with a calculated serum osmolarity of ≥ 295 mOsmol/l were classified as dehydrated, indicating a state of free water deficit [1, 11].；Overall, participants had a mean age of 82.2 ± 6.8 years and 70% were female, representing a typical sex distribution in acute geriatric wards.；Agreement beyond chance was slight (Cohen’s κ = 0.112, p = 0.011).The McNemar test was significant (p < 0.001), demonstrating systematic disagreement between calculated osmolarity and the clinical reference standard, driven primarily by an excess of false positives relative to false negatives.
局限
All forms of dehydration may be associated with a broad spectrum of clinical symptoms and functional limitations [2].；However, in older patients, clinical signs and symptoms are often non-specific, and there is no universally accepted single gold standard for diagnosing dehydration.；Finally, the therapy of acute dehydration is rather simple, however, evidence for effective prevention strategies remains limited, and the optimal daily fluid intake for older adults is not well established [11].While different types of dehydration exist, low-intake dehydration is considered the most common form in older adults, leading to hypertonic dehydration [11].
对本项目的价值
中等价值：属「代谢 / 内分泌 / 肝肾老化」方向；代谢 / 内分泌 / 肝肾老化的界面栏目可用作本项目文献库与综述素材。 ｜ 价值分 2.6/5（★★★☆☆）
全文来源
PubMed PMC JATS（正文 30,909 字符，题名指纹 0.93，已过 PubMed PMCID 官方关联 + 题名指纹 + 正文长度归属校验）
原文题录
- 中文题名：计算血清渗透压 versus 临床印象识别老年住院患者脱水的诊断效能
- 英文标题：Diagnostic performance of calculated serum osmolarity versus clinical impression for identifying dehydration in older hospitalized patients.
- 期刊与标识：BMC geriatrics · PMID 42972249 · DOI 10.1186/s12877-026-08503-6 · PMC PMC13726267