Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Fisciano, Italy.
Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.
J Biol Regul Homeost Agents. 2019 Mar-Apr;33(2 Suppl. 1):125-132. XIX Congresso Nazionale S.I.C.O.O.P. Societa' Italiana Chirurghi Ortopedici Dell'ospedalita' Privata Accreditata.
This study investigated the prevalence of hyponatremia during the hospital stay, in a cohort of elderly patients with hip fractures who underwent surgery within 48 h from admission. Records data were retrieved from the database of the San Giovanni di Dio e Ruggi d'Aragona Hospital of Salerno, Italy. All elderly patients (≥65 years old) with a documented hip fracture that underwent surgery within 48 h from admission, between 2016 and 2018, were included and divided in 4 subgroups according to their sex and type of fracture. Serum sodium concentration were monitored during the hospital stay and collected at admission, before surgery, after surgery and at discharge. The overall prevalence of hyponatremia was 23.99% (n=71/295), (24.3%, n=57/234 for female patients and 22.9%, n=14/61 for male patients). The percentage of hyponatremic patients with an intracapsular hip fracture was 27.17% (n=25/92), and 22.66% (n=46/203) in patients with an extracapsular hip fracture. The highest value of mean serum sodium concentration (139.2 mmol/L±4.4 SD) was found at the hospital discharge phase, and the lowest value (138.4 mmol/L±4.3 SD) was found during the pre-surgery phase. The lowest mean value of serum sodium was found before surgery, while the highest was after surgery. This could suggest that the early operative treatment and the accurate in-hospital monitoring are effective to treat or prevent this condition.
本研究调查了在意大利萨莱诺圣乔瓦尼迪迪奥和鲁吉达阿拉贡纳医院的数据库中,在入院后 48 小时内接受手术的老年髋部骨折患者住院期间低钠血症的患病率。所有年龄≥65 岁、有记录的髋部骨折且在入院后 48 小时内接受手术的老年患者均被纳入研究,并根据其性别和骨折类型分为 4 个亚组。在住院期间监测血清钠浓度,并在入院时、手术前、手术后和出院时采集。低钠血症的总体患病率为 23.99%(n=71/295),(24.3%,n=57/234 为女性患者,22.9%,n=14/61 为男性患者)。囊内髋部骨折的低钠血症患者百分比为 27.17%(n=25/92),囊外髋部骨折的低钠血症患者百分比为 22.66%(n=46/203)。血清钠浓度的平均值最高值(139.2mmol/L±4.4SD)在出院时,最低值(138.4mmol/L±4.3SD)在手术前。血清钠的最低平均值出现在手术前,而最高值出现在手术后。这表明早期手术治疗和准确的住院监测可有效治疗或预防这种情况。