Yonai Yaniv, Ben Natan Merav, Steinfeld Yaniv, Berkovich Yaron
The Orthopedics B Department, Hillel Yaffe Medical Center, Hadera, Israel.
Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, P.O.B. 169, 38100 Hadera, Israel.
Indian J Orthop. 2022 Feb 4;56(5):856-861. doi: 10.1007/s43465-021-00557-5. eCollection 2022 May.
It is unclear whether climate may play a role in the association between hyponatremia on admission and increased mortality risk among hip fracture patients following a hip fracture repair surgery. We aimed (1) to explore if there is any combined effect of seasonality and hyponatremia on the occurrence of hip fractures among older adults and (2) to explore the effect of hyponatremia on admission on mortality rate at latest follow-up among hip fracture patients following a hip fracture repair surgery in the context of the subtropical climate of Israel.
We conducted a retrospective cohort study of older patients who underwent a surgery for hip fracture repair in a major 495-bed hospital located in northern-central Israel in 2017-2020. Patients were divided into two groups: hyponatremic ( = 107) and normonatremic ( = 757) patients. Characteristics of the two groups were compared, as well as their survival probability.
Hyponatremic patients were most frequently hospitalized during winter season. Such seasonal variation was observed only among hyponatremic patients. Moreover, patients who were hospitalized during winter season were more likely to be hyponatremic on admission. Hyponatremia on admission was found as a significant independent predictor of mortality rate at latest follow-up (adjusted hazard ratio = 0.377 [0.26-0.52]), when compared to normonatremia.
There is a combined effect of seasonality and hyponatremia on the occurrence of hip fractures among older adults, with hyponatremic patients being at a higher risk of sustaining a hip fracture during winter season than during other seasons. In addition, the association between hyponatremia on admission and mortality rate at latest follow-up among hip fracture patients has been confirmed.
目前尚不清楚气候是否会在髋部骨折修复手术后髋部骨折患者入院时低钠血症与死亡风险增加之间的关联中发挥作用。我们旨在（1）探讨季节性和低钠血症对老年人髋部骨折发生是否存在联合影响，以及（2）在以色列亚热带气候背景下，探讨髋部骨折修复手术后髋部骨折患者入院时低钠血症对最新随访时死亡率的影响。
我们对2017 - 2020年在以色列中北部一家拥有495张床位的大型医院接受髋部骨折修复手术的老年患者进行了一项回顾性队列研究。患者分为两组：低钠血症组（n = 107）和正常钠血症组（n = 757）。比较了两组的特征及其生存概率。
低钠血症患者最常在冬季住院。这种季节性变化仅在低钠血症患者中观察到。此外，冬季住院的患者入院时更可能出现低钠血症。与正常钠血症相比，入院时低钠血症被发现是最新随访时死亡率的显著独立预测因素（调整后的风险比 = 0.377 [0.26 - 0.52]）。
季节性和低钠血症对老年人髋部骨折的发生存在联合影响，低钠血症患者在冬季发生髋部骨折的风险高于其他季节。此外，髋部骨折患者入院时低钠血症与最新随访时死亡率之间的关联已得到证实。
