Skip to main content
Top
Published in: Osteoporosis International 1/2016

01-01-2016 | Original Article

Hyponatremia and hypernatremia are associated with increased 30-day mortality in hip fracture patients

Authors: C. M. Madsen, C. Jantzen, J. B. Lauritzen, B. Abrahamsen, H. L. Jorgensen

Published in: Osteoporosis International | Issue 1/2016

Login to get access

Abstract

Summary

Using data from the Danish national registries on 7317 patients, this study shows that abnormal plasma sodium levels, in the form of hyponatremia and hypernatremia, are prevalent and associated with increased 30-day mortality in hip fracture patients.

Introduction

The aim of this study was to examine the prevalence of hyponatremia and hypernatremia in patients admitted with a fractured hip as well as the association with 30-day in mortality in these patients.

Methods

A total of 7317 hip fracture patients (aged 60 years or above) with admission plasma sodium measurements were included. Data on comorbidity, medication, and death was retrieved from Danish national registries. The association between plasma sodium and mortality was examined using Cox proportional hazard models.

Results

The prevalence of hyponatremia and hypernatremia on admission was 19.0 and 1.7 %, respectively. Thirty-day mortality was increased for patients with hyponatremia (12.2 %, p = 0.005) and hypernatremia (15.5 %, p = 0.03) compared to normonatremic patients (9.6 %). After adjustment for possible confounding factors, hyponatremia (1.38 [1.16–1.64], p = 0.0003) and hypernatremia (1.71 [1.08–2.70], p = 0.02) were still associated with increased risk of death by 30 days. Looking at the association between changes in plasma sodium during admission and mortality, there was no difference between patients with normalized and persistent hyponatremia (10.4 vs 11.3 %, p = 0.6) while a lower mortality was found for normalized hypernatremia compared to persistent hypernatremia (12.4 vs 33.3 %, p = 0.03).

Conclusions

This study shows that abnormal plasma sodium levels are prevalent in patients admitted with a fractured hip and that both hyponatremia and hypernatremia are associated with increased risk of death within 30 days of admission.
Literature
3.
go back to reference Holland-Bill L, Christiansen CF, Heide-Jørgensen U et al (2015) Hyponatremia and mortality risk: a Danish cohort study of 279 508 acutely hospitalized patients. Eur J Endocrinol 173:71–81. doi:10.1530/EJE-15-0111 PubMedCrossRef Holland-Bill L, Christiansen CF, Heide-Jørgensen U et al (2015) Hyponatremia and mortality risk: a Danish cohort study of 279 508 acutely hospitalized patients. Eur J Endocrinol 173:71–81. doi:10.​1530/​EJE-15-0111 PubMedCrossRef
5.
go back to reference Mc Causland FR, Wright J, Waikar SS (2014) Association of serum sodium with morbidity and mortality in hospitalized patients undergoing major orthopedic surgery. J Hosp Med 9:297–302. doi:10.1002/jhm.2168 PubMedCrossRef Mc Causland FR, Wright J, Waikar SS (2014) Association of serum sodium with morbidity and mortality in hospitalized patients undergoing major orthopedic surgery. J Hosp Med 9:297–302. doi:10.​1002/​jhm.​2168 PubMedCrossRef
18.
go back to reference Antonelli Incalzi R, Gemma A, Capparella O et al (1993) Post-operative electrolyte imbalance: its incidence and prognostic implications for elderly orthopaedic patients. Age Ageing 22:325–331PubMedCrossRef Antonelli Incalzi R, Gemma A, Capparella O et al (1993) Post-operative electrolyte imbalance: its incidence and prognostic implications for elderly orthopaedic patients. Age Ageing 22:325–331PubMedCrossRef
23.
go back to reference Quan H, Sundararajan V, Halfon P et al (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43:1130–1139PubMedCrossRef Quan H, Sundararajan V, Halfon P et al (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43:1130–1139PubMedCrossRef
27.
go back to reference Jensen AG, Wachmann CH, Poulsen KB et al (1999) Risk factors for hospital-acquired Staphylococcus aureus bacteremia. Arch Intern Med 159:1437–1444PubMedCrossRef Jensen AG, Wachmann CH, Poulsen KB et al (1999) Risk factors for hospital-acquired Staphylococcus aureus bacteremia. Arch Intern Med 159:1437–1444PubMedCrossRef
28.
go back to reference Bratusch-Marrain PR, DeFronzo RA (1983) Impairment of insulin-mediated glucose metabolism by hyperosmolality in man. Diabetes 32:1028–1034PubMedCrossRef Bratusch-Marrain PR, DeFronzo RA (1983) Impairment of insulin-mediated glucose metabolism by hyperosmolality in man. Diabetes 32:1028–1034PubMedCrossRef
29.
go back to reference Kozeny GA, Murdock DK, Euler DE et al (1985) In vivo effects of acute changes in osmolality and sodium concentration on myocardial contractility. Am Heart J 109:290–296PubMedCrossRef Kozeny GA, Murdock DK, Euler DE et al (1985) In vivo effects of acute changes in osmolality and sodium concentration on myocardial contractility. Am Heart J 109:290–296PubMedCrossRef
Metadata
Title
Hyponatremia and hypernatremia are associated with increased 30-day mortality in hip fracture patients
Authors
C. M. Madsen
C. Jantzen
J. B. Lauritzen
B. Abrahamsen
H. L. Jorgensen
Publication date
01-01-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 1/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3423-4

Other articles of this Issue 1/2016

Osteoporosis International 1/2016 Go to the issue