Chronic hyponatremia in patients with proximal femoral fractures after low energy trauma: A retrospective study in a level-1 trauma center

• Published in: Bone Reports Vol. 12; p. 100234
• Main Authors: Hoffmann, Daniel Bernd, Popescu, Christian, Komrakova, Marina, Welte, Lena, Saul, Dominik, Lehmann, Wolfgang, Hawellek, Thelonius, Beil, Frank Timo, Dakna, Mohammed, Sehmisch, Stephan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2020; Elsevier
• Subjects: Electrolyte disorder; Geriatric trauma; Hip arthroplasty; Hyponatremia; Low energy trauma; Proximal femur fracture; Hyponatremia; Low energy trauma; Proximal femur fracture; Geriatric trauma; Electrolyte disorder; Hip arthroplasty
• ISSN: 2352-1872; 2352-1872
• DOI: 10.1016/j.bonr.2019.100234

We evaluated the prevalence and influence of chronic hyponatremia in patients with low energy trauma. We also investigated the influence of medication and diseases on hyponatremia.
This retrospective study included 314 cases of proximal femoral fracture due to low energy trauma. Patients were treated in the University Medical Center Goettingen within 3 years. Hyponatremia was defined as serum sodium <135 mmol/L at admission.
Overall, 15.6% of patients in the low energy trauma group had hyponatremia. Among patients older than 80 years, women showed distinctly higher rates of hyponatremia (female: 16.4%; male: 5.9%). In contrast only 4.7% of patients who underwent elective hip arthroplasty showed hyponatremia. Patients on sartanes and aldosterone antagonists showed significantly higher rates of hyponatremia. Alcoholism was significantly associated with hyponatremia.
We confirmed a high prevalence of chronic hyponatremia in patients with fractures due to low energy trauma. Our data underscore chronic hyponatremia as a contributing factor to hip fractures. Women older than 80 have a higher risk of developing hyponatremia. Sartanes, aldosterone antagonists, and alcohol disease are associated with hyponatremia. Treating hyponatremia may decrease the risk of fracture after low energy trauma. Therefore, physicians of different specialties should focus on treatment of chronic hyponatremia to reduce the fracture rate associated with low energy trauma.
•15.6% of patients with prox. femur fracture after low energy trauma had hyponatremia.•Hyponatremia rate in group of patients before hip arthroplasty was only 4.7%.•Sartanes, aldosterone antagonists, and alcohol disease are associated with hyponatremia.•Women older than 80 have a higher risk of developing hyponatremia.