Hyponatremia Is Associated with Worse Outcomes from Fall Injuries in the Elderly

Spencer C. H. Kuo, Pao-Jen Kuo, Cheng-Shyuan Rau, Shao-Chun Wu, Shiun-Yuan Hsu and Ching-Hua Hsieh
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Spencer C. H. Kuo: Division of Trauma Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Niao-Song District, Kaohsiung City 833, Taiwan
Pao-Jen Kuo: Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan
Cheng-Shyuan Rau: Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan
Shao-Chun Wu: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan
Shiun-Yuan Hsu: Division of Trauma Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Niao-Song District, Kaohsiung City 833, Taiwan
Ching-Hua Hsieh: Division of Trauma Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Niao-Song District, Kaohsiung City 833, Taiwan

IJERPH, 2017, vol. 14, issue 5, 1-11

Abstract: Background : Hyponatremia has been proposed as a contributor to falls in the elderly, which have become a major global issue with the aging of the population. This study aimed to assess the clinical presentation and outcomes of elderly patients with hyponatremia admitted due to fall injuries in a Level I trauma center. Methods : We retrospectively reviewed data obtained from the Trauma Registry System for trauma admissions from January 2009 through December 2014. Hyponatremia was defined as a serum sodium level <135 mEq/L, and only patients who had sustained a fall at ground level (<1 m) were included. We used Chi-square tests, Student t -tests, and Mann-Whitney U tests to compare elderly patients (age ?65 years) with hyponatremia (n = 492) to those without (n = 2002), and to adult patients (age 20–64 years) with hyponatremia (n = 125). Results : Significantly more elderly patients with hyponatremia presented to the emergency department (ED) due to falls compared to elderly patients without hyponatremia (73.7% vs. 52.6%; OR: 2.5, 95% CI: 2.10–3.02; p < 0.001). Elderly patients with hyponatremia presented with a worse outcome, measured by significantly higher odds of intubation (OR: 2.4, 95% CI: 1.15–4.83; p = 0.025), a longer in-hospital length of stay (LOS) (11 days vs. 9 days; p < 0.001), higher proportion of intensive care unit (ICU) admission (20.9% vs. 16.2%; OR: 1.4, 95% CI: 1.07–1.76; p = 0.013), and higher mortality (OR: 2.5, 95% CI: 1.53–3.96; p < 0.001), regardless of adjustment by Injury Severity Scores (ISS) (AOR: 2.4, 95% CI: 1.42–4.21; p = 0.001). Conclusions : Our results show that hyponatremia is associated with worse outcome from fall-related injuries in the elderly, with an increased ISS, longer LOS, and a higher risk of death.

Keywords: hyponatremia; fall injury; elderly; injury severity score; trauma; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2017
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