Chronic hyponatremia in patients with proximal femoral fractures after low energy trauma: A retrospective study in a level-1 trauma center
Daniel Bernd Hoffmann,
Christian Popescu,
Marina Komrakova,
Lena Welte,
Dominik Saul,
Wolfgang Lehmann,
Thelonius Hawellek,
Frank Timo Beil,
Mohammed Dakna,
Stephan Sehmisch
Affiliations
Daniel Bernd Hoffmann
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany; Corresponding author at: Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Robert Koch St. No. 40, 37075 Goettingen, Germany.
Christian Popescu
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
Marina Komrakova
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
Lena Welte
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
Dominik Saul
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
Wolfgang Lehmann
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
Thelonius Hawellek
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
Frank Timo Beil
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
Mohammed Dakna
Department of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany
Stephan Sehmisch
Department of Trauma-, Orthopaedic- and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
Introduction: We evaluated the prevalence and influence of chronic hyponatremia in patients with low energy trauma. We also investigated the influence of medication and diseases on hyponatremia. Material and methods: This retrospective study included 314 cases of proximal femoral fracture due to low energy trauma. Patients were treated in the University Medical Center Goettingen within 3 years. Hyponatremia was defined as serum sodium <135 mmol/L at admission. Results: Overall, 15.6% of patients in the low energy trauma group had hyponatremia. Among patients older than 80 years, women showed distinctly higher rates of hyponatremia (female: 16.4%; male: 5.9%). In contrast only 4.7% of patients who underwent elective hip arthroplasty showed hyponatremia. Patients on sartanes and aldosterone antagonists showed significantly higher rates of hyponatremia. Alcoholism was significantly associated with hyponatremia. Conclusions: We confirmed a high prevalence of chronic hyponatremia in patients with fractures due to low energy trauma. Our data underscore chronic hyponatremia as a contributing factor to hip fractures. Women older than 80 have a higher risk of developing hyponatremia. Sartanes, aldosterone antagonists, and alcohol disease are associated with hyponatremia. Treating hyponatremia may decrease the risk of fracture after low energy trauma. Therefore, physicians of different specialties should focus on treatment of chronic hyponatremia to reduce the fracture rate associated with low energy trauma.
