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Int. J. Environ. Res. Public Health 2017, 14(5), 460; doi:10.3390/ijerph14050460

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

1
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
2
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan
3
Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan
4
Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 13 March 2017 / Revised: 17 April 2017 / Accepted: 20 April 2017 / Published: 26 April 2017
(This article belongs to the Section Global Health)
View Full-Text   |   Download PDF [578 KB, uploaded 26 April 2017]   |  

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. View Full-Text
Keywords: hyponatremia; fall injury; elderly; injury severity score; trauma; mortality hyponatremia; fall injury; elderly; injury severity score; trauma; mortality
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MDPI and ACS Style

Kuo, S.C.H.; Kuo, P.-J.; Rau, C.-S.; Wu, S.-C.; Hsu, S.-Y.; Hsieh, C.-H. Hyponatremia Is Associated with Worse Outcomes from Fall Injuries in the Elderly. Int. J. Environ. Res. Public Health 2017, 14, 460.

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