Hip fracture post-operation dysnatremia and Na+-courses in different cognitive and functional patient groups.
The aim of the study was to investigate Na(+)-course of hip fracture patients in relation to demographic and clinical parameters. Data on 155 older hip fracture patients were analyzed retrospectively. Clinical parameters and serum Na(+) on admission (Na1), during 24h pre-op. (Na2), during 24h post-op. (Na3), and pre-discharge (Na4) were recorded. Hyponatremia and hypernatremia rates pre- and post-operation were 26.5%, 2.6%, 24.5% and 5.8%. Higher Na3 (138.76 ± 4.4 mEq/l) vs. Na1 (137.69 ± 4.5 mEq/l) (p = 0.004) and correlation between age and Na3 (p = 0.021) was found. Mean serum Na(+) of impaired mental status (IMS) vs. normal patients and of partially/independent vs. dependent patients were higher (p < 0.05). More complications occurred in IMS patients tending to higher Na3 in patients with complications. No differences in Na(+)-courses were found according to sex or co-morbidities. Dysnatremia is highly prevalent in older hip fracture patients. A distinct post-operative increase in serum Na(+) was found, higher in the cognitively and functionally impaired patients. It seems that the Na(+) increase characterizes more IMS patients who suffer more complications, but does not necessarily indicate complications. We recommend surveillance of serum Na(+), particularly in cognitively and functionally impaired older patients in whom the risk of hypernatremia and complications is higher.
Department of Geriatrics, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, 39 Jabotinski St, Petah Tikva 49100, Israel. beloy@clalit.org.il
Yichayaou
Y
Beloosesky
Avital
A
Hershkovitz
Benyamin
B
Solovey
Moshe
M
Salai
Avraham
A
Weiss
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006955:Hypernatremia / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D007010:Hyponatremia / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000097:blood*
D012964:Sodium