Thirst common, under-recognized in admitted patients

Thirst is a major cause of distress among patients on nasogastric tubes (NGT) and nil-by-mouth (NBM) orders, a recent Singapore study has found. However, healthcare teams often overlook thirst, leading to a general feeling of under-recognition among patients.

Researchers conducted a descriptive study including 88 adult patients on NGT and NBM, as well as 31 patients on NBM alone, undergoing treatment at the National University Hospital. The average age in the overall cohort was 64.3±14.9 years, most were male (67.0 percent) and of Chinese ethnicity (80.7 percent).

Interviews revealed that majority (69.3 percent; n=61) of patients reported thirst, which tended to be more common in the NGT + NBM group, though only marginally (75.4 percent vs 58.1 percent; p=0.1). Pain and hunger scores were not correlated with thirst indices.

Only 13.6 percent of the participants said that they were asked about their thirst by doctors or nurses. Those who were thirsty reported that they were asked less. To help relieve thirst, patients were usually allowed sips of water or given ice chips; both interventions, however, did not lower thirst indices.

In terms of thirst predictors, the researchers found that those who had previous stroke tended to report feeling thirsty more often, as did patients who were diabetic. NGT + NBM thirsty participants who were euvolemic had higher thirst intensity than their hypovolemic counterparts. Age, treatment during admission, and duration of NGT or NBM had no impact on thirst.

“Patients should be actively asked about thirst and what it means to them, especially in the presence of high-yield interventions. We hope that future studies can be done in other populations, such as home care and elderly, with plans for low-cost intervention to be examined subsequently to improve quality of life for our patients,” the researchers said.