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首页> 外文期刊>Journal of Clinical Medicine Research >Prognosis of Hyponatremia in Elderly Patients With Fragility Fractures
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Prognosis of Hyponatremia in Elderly Patients With Fragility Fractures

机译：低钠血症在老年人脆性骨折中的预后

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Background: Hyponatremia (serum sodium < 135 mmol/L) is the commonest electrolyte imbalance encountered in clinical practice. It is associated with multiple poor clinical outcomes including increased length of hospital stay, institutionalization and mortality. Prevalence of hyponatremia is higher in frail patient groups, and elderly patients with fragility fractures (EPFF) are particularly susceptible. This study aimed to establish the impact of hyponatremia on total length of inpatient stay (TLOS), need for inpatient rehabilitation and mortality in EPFF.Methods: Prospective observational study of consenting adults aged ≥ 65 years admitted with a fragility fracture to a university hospital between January 7, and April 4, 2013. Demographic and clinical data, length of hospital stay, discharge destination and any participant deaths were recorded. Prevalence of hyponatremia on admission and incidence of cases developing in hospital were reported. Basic demographic data and serum sodium results were included in multivariate linear regression models for TLOS. Difference in mortality rate and proportion of individuals discharged to inpatient rehabilitation between the hyponatremic and normonatremic group were tested using Chi-squared and Fisher’s exact tests. Unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were also calculated.Results: Of 212 cases, 127 (60%) EPFF were recruited (mean age 79 years, 78% female). Of those not recruited, 66 had incapacity to consent and 19 refused participation. Thirty-three cases of hyponatremia were identified; point prevalence on admission was 13.4% and a further 12.6% developed hyponatremia during admission. There were no statistically significant differences in patient characteristics between the hyponatremic and normonatremic group. Hyponatremic participants had a 66.7% increased time from admission to surgery (P = 0.014) and a 51.5% increased length of index hospital stay (P = 0.006). Factors independently associated with increased TLOS were age (P = 0.03) and drop in sodium during admission (P < 0.001). Mortality rate and proportion of participants discharged to inpatient rehabilitation were higher in the hyponatremic group (OR 4.2 (95% CI: 0.9 - 19.8) and 2.2 (95% CI: 0.9 - 5.1), respectively), but figures did not reach statistical significance.Conclusions: Hyponatremia is highly prevalent in EPFF, seen in 33/127 cases (26%), and is associated with increased length of index hospital stay. Drop in serum sodium during admission was independently associated with increased TLOS.J Clin Med Res. 2015;7(1):45-51doi: http://dx.doi.org/10.14740/jocmr1984w
机译：背景：低钠血症（血清钠<135 mmol / L）是临床实践中最常见的电解质失衡。它与多种不良的临床结局相关，包括住院时间延长，机构化和死亡率增加。在体弱的患者群体中，低钠血症的患病率较高，患有脆性骨折（EPFF）的老年患者尤其容易受到影响。本研究旨在确定低钠血症对EPFF患者住院总时长（TLOS），住院康复需求和死亡率的影响。方法：前瞻性观察性研究：同意接受≥65岁易碎性骨折入院的成人同意2013年1月7日和4月4日。记录了人口统计学和临床​​数据，住院时间，出院目的地以及所有参与者死亡。据报道低钠血症的住院率和住院病例的发生率。基本的人口统计学数据和血清钠结果包括在TLOS的多元线性回归模型中。使用卡方和费舍尔精确检验来检验低钠血症组和正常钠血症组之间的死亡率和出院住院患者的比例差异。结果：在212例病例中，招募了127例（60％）EPFF（平均年龄79岁，女性78％）。在没有被招募的人中，有66人无能力表示同意，有19人拒绝参加。确定了33例低钠血症;入院时的点流行率为13.4％，入院时进一步发生低钠血症为12.6％。低钠血症组和降钠血症组之间的患者特征无统计学差异。低钠血症参与者从入院到手术的时间增加了66.7％（P = 0.014），而住院时间延长了51.5％（P = 0.006）。与TLOS升高独立相关的因素是年龄（P = 0.03）和入院期间钠的下降（P <0.001）。低钠血症组的死亡率和住院康复出院者的死亡率较高（分别为OR 4.2（95％CI：0.9-19.8）和2.2（95％CI：0.9-5.1）），但数字没有统计学意义结论：低钠血症在EPFF中非常普遍，见33/127例（26％），并与住院时间延长有关。入院期间血清钠的下降与TLOS的升高独立相关。JClin Med Res。 2015; 7（1）：45-51doi：http://dx.doi.org/10.14740/jocmr1984w

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