Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.

Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.

<h4>Introduction</h4>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 mortality, longer hospital stay, falls and fractures. Prevalence is higher in...

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Autores principales: Kirsten Cumming, Graeme E Hoyle, James D Hutchison, Roy L Soiza
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2014
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Acceso en línea:https://doaj.org/article/1bf52591399745fe858e9d3f5d032c72
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spelling oai:doaj.org-article:1bf52591399745fe858e9d3f5d032c722021-11-18T08:33:35ZPrevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.1932-620310.1371/journal.pone.0088272https://doaj.org/article/1bf52591399745fe858e9d3f5d032c722014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24505459/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>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 mortality, longer hospital stay, falls and fractures. Prevalence is higher in frail patient groups, and elderly patients with fragility fractures (EPFF) are particularly susceptible. Euvolemic hyponatremia due to syndrome of inappropriate anti-diuretic hormone (SIADH) is widely assumed to be the commonest cause. However, little is known about the epidemiology and etiology of hyponatremia in EPFF. This study established prevalence, incidence and etiology of hyponatremia in EPFF.<h4>Methods</h4>Prospective observational study of consenting adults aged ≥65 years admitted with a fragility fracture to a university hospital between 7th January and 4th April 2013. Prevalence of hyponatremia on admission and incidence of cases developing in hospital were reported. Etiology of cases of hyponatremia was determined by consensus of an expert panel using pre-specified data collected daily.<h4>Results</h4>127/212 (60%) EPFF were recruited (mean age 79 yrs, 78% female). Two participants withdrew mid-study. Of those not recruited, 66 had incapacity to consent and 19 refused participation. Point prevalence of hyponatremia on admission was 13.4% and a further 12.6% developed hyponatremia during admission. Hypovolemic hyponatremia was predominant (70%). 73% of cases were multi-factorial in etiology. The commonest potentially causative factors in cases of hyponatremia were thiazide diuretics (76%), dehydration (70%), proton pump inhibitors (70%), SIADH (27%) and mirtazapine (15%).<h4>Conclusion</h4>Hyponatremia is highly prevalent in EPFF, seen in 26% of cases. Dehydration and prescription of thiazide diuretics and proton pump inhibitors were the commonest potentially causative factors, not SIADH.Kirsten CummingGraeme E HoyleJames D HutchisonRoy L SoizaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e88272 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Kirsten Cumming
Graeme E Hoyle
James D Hutchison
Roy L Soiza
Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.
description <h4>Introduction</h4>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 mortality, longer hospital stay, falls and fractures. Prevalence is higher in frail patient groups, and elderly patients with fragility fractures (EPFF) are particularly susceptible. Euvolemic hyponatremia due to syndrome of inappropriate anti-diuretic hormone (SIADH) is widely assumed to be the commonest cause. However, little is known about the epidemiology and etiology of hyponatremia in EPFF. This study established prevalence, incidence and etiology of hyponatremia in EPFF.<h4>Methods</h4>Prospective observational study of consenting adults aged ≥65 years admitted with a fragility fracture to a university hospital between 7th January and 4th April 2013. Prevalence of hyponatremia on admission and incidence of cases developing in hospital were reported. Etiology of cases of hyponatremia was determined by consensus of an expert panel using pre-specified data collected daily.<h4>Results</h4>127/212 (60%) EPFF were recruited (mean age 79 yrs, 78% female). Two participants withdrew mid-study. Of those not recruited, 66 had incapacity to consent and 19 refused participation. Point prevalence of hyponatremia on admission was 13.4% and a further 12.6% developed hyponatremia during admission. Hypovolemic hyponatremia was predominant (70%). 73% of cases were multi-factorial in etiology. The commonest potentially causative factors in cases of hyponatremia were thiazide diuretics (76%), dehydration (70%), proton pump inhibitors (70%), SIADH (27%) and mirtazapine (15%).<h4>Conclusion</h4>Hyponatremia is highly prevalent in EPFF, seen in 26% of cases. Dehydration and prescription of thiazide diuretics and proton pump inhibitors were the commonest potentially causative factors, not SIADH.
format article
author Kirsten Cumming
Graeme E Hoyle
James D Hutchison
Roy L Soiza
author_facet Kirsten Cumming
Graeme E Hoyle
James D Hutchison
Roy L Soiza
author_sort Kirsten Cumming
title Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.
title_short Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.
title_full Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.
title_fullStr Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.
title_full_unstemmed Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.
title_sort prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/1bf52591399745fe858e9d3f5d032c72
work_keys_str_mv AT kirstencumming prevalenceincidenceandetiologyofhyponatremiainelderlypatientswithfragilityfractures
AT graemeehoyle prevalenceincidenceandetiologyofhyponatremiainelderlypatientswithfragilityfractures
AT jamesdhutchison prevalenceincidenceandetiologyofhyponatremiainelderlypatientswithfragilityfractures
AT roylsoiza prevalenceincidenceandetiologyofhyponatremiainelderlypatientswithfragilityfractures
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