Kumar R Vijay, Manchekar Mayur P, Kashid Manoj, Rajauria Surbhi, Rai Sanjay K
Department of Medicine, Military Hospital, Chennai, Tamil Nadu, India.
Department of Orthopaedics, SMBT Medical College, Igatpuri, Nashik, Maharashtra, India.
J Family Med Prim Care. 2023 Sep;12(9):1843-1848. doi: 10.4103/jfmpc.jfmpc_2124_22. Epub 2023 Sep 30.
Fracture around the hip is amongst the most common and serious fractures in the elderly, which leads to significant morbidity and mortality. In literature, many authors noted that even mild hyponatremia adversely affects bone, leading to an increased incidence of fractures. We aim to determine whether chronic hyponatremia (>90-day duration) increases the risk of hip fracture in the elderly and whether primary care physicians can help to prevent it.
During the period from January 2020 to March 2022, we identified 145 patients aged between 65 and 90 years who were admitted to the hospital with hip fractures following a fall and compared them with 140 healthy controls. We recorded sodium (Na) serum levels in all included patients at the time of arrival and consequently for 3 days and compared them with those of controls. Logistic regression was used to calculate odds ratios (ORs). We measured serum Na levels for 3 days and took the average to ascertain hyponatremia.
In the study, the odds of hyponatremia were 70.3% with a confidence interval of 95% versus 3.6% in controls ( = 0.05). Age and hyponatremia were strongly associated with hip fractures following a fall. With a 5-year increase in age, the univariate OR for hip fracture increased by 5.67 ( < 0.0001). After adjusting for age, cases were nearly six times more likely to be hyponatremic than controls (OR = 4.90, = 0.04).
In our study, we noted that even mild chronic hyponatremia in old age increased the chance of falls. Addressing hyponatremia in the elderly may reduce the risk of falls and minimize hip fractures.
髋部周围骨折是老年人中最常见且最严重的骨折之一，会导致显著的发病率和死亡率。在文献中，许多作者指出，即使是轻度低钠血症也会对骨骼产生不利影响，导致骨折发生率增加。我们旨在确定慢性低钠血症（持续时间>90天）是否会增加老年人髋部骨折的风险，以及初级保健医生是否能够帮助预防这种情况。
在2020年1月至2022年3月期间，我们确定了145名年龄在65岁至90岁之间因跌倒导致髋部骨折而入院的患者，并将他们与140名健康对照者进行比较。我们记录了所有纳入患者入院时以及随后3天的血清钠（Na）水平，并与对照组进行比较。采用逻辑回归计算比值比（OR）。我们测量了3天的血清钠水平并取平均值以确定低钠血症。
在该研究中，低钠血症的几率为70.3%，95%置信区间，而对照组为3.6%（P = 0.05）。年龄和低钠血症与跌倒后髋部骨折密切相关。年龄每增加5岁，髋部骨折的单因素OR增加5.67（P < 0.0001）。在调整年龄后，病例发生低钠血症的可能性比对照组高近6倍（OR = 4.90，P = 0.04）。
在我们的研究中，我们注意到老年时即使是轻度慢性低钠血症也会增加跌倒的几率。解决老年人的低钠血症问题可能会降低跌倒风险并使髋部骨折的发生率降至最低。
