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- Title
Hyponatremia, Hypokalemia, and Fragility Fractures in Old Patients: More than an Association?
- Authors
Schiara, Laura Anna Maria; Moirano, Giovenale; Grosso, Elena; Richiardi, Lorenzo; Tibaldi, Michela; Spertino, Elena; Vezza, Carlotta; Isaia, Giovanni Carlo; Massaia, Massimiliano; D'Amelio, Patrizia
- Abstract
<bold>Purpose: </bold>Hyponatremia and hypokalemia are common among elderly and have been associated with osteoporosis, we evaluate the role of these electrolytes as risk for fragility fractures.<bold>Methods: </bold>This study is divided in two parts: one retrospective and one prospective. We retrospectively collected data on urgently admitted patients for femoral fragility fractures (Fx) or for acute myocardial infarction (AMI), and patients admitted for elective hip/knee replacement surgery for osteoarthrosis (OA). Age, sex, serum sodium, potassium, creatinine, and comorbidities were recorded. We enrolled prospectively in-patients from our unit: age, sex, comorbidities, drugs, and fragility fractures were recorded. Blood electrolytes were measured. Cognitive function, nutrition, muscular strength, and balance were evaluated by standard tests. The mortality rate was recorded with a follow-up after hospital discharge.<bold>Results: </bold>The retrospective study included 2166 subjects: 702 Fx and 1464 controls (907 AMI, 557 OA): the prevalence of hyponatremia was similar in Fx and AMI, whereas it was higher in Fx with respect to OA (p < 0.001) as well as hypokalemia (p < 0.001). Sodium decrease was associated with higher fracture risk. Among the 284 subjects included in the prospective study, 50 patients were hyponatremic, more likely malnourished, and presented a higher prevalence of fragility fractures (p = 0.008). They had a higher mortality after hospital discharge (HR = 1.80, p = 0.005), however, this association disappears after correction for confounding variables.<bold>Conclusions: </bold>We suggest that hyponatremia and hypokalemia have to be considered as a marker of poor health more than an independent fracture risk.
- Subjects
HYPOKALEMIA; HYPONATREMIA; OLDER patients; FEMUR neck; HOSPITAL admission &; discharge; KNEE surgery; FRACTURE healing; MUSCLE strength; SODIUM; POTASSIUM; RETROSPECTIVE studies; FEMUR; CREATININE; LONGITUDINAL method; DISEASE complications
- Publication
Calcified Tissue International, 2020, Vol 106, Issue 6, p599
- ISSN
0171-967X
- Publication type
journal article
- DOI
10.1007/s00223-020-00675-6