Abstract: TH-PO1141

Mild Chronic Prolonged Hyponatremia at Admission Is Associated with Long Term Mortality in Patients with Hip Fracture Repair

Session Information

Category: Fluid, Electrolytes, and Acid-Base

  • 704 Fluid, Electrolyte, Acid-Base Disorders

Authors

  • Ayus, Juan Carlos, Renal Consultants of Houston, Houston, Texas, United States
  • Fuentes, Nora, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • Moritz, Michael L., Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States
  • Go, Alan S., Kaiser Permanente Northern California, Oakland, California, United States
  • Negri, Armando Luis, Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
Background

A recent study indicates that chronic prolonged hyponatremia is a significant risk factor for hip fracture in the elderly (Ayus JC; NDT 2016; 31(10):1662-9). No information exists with respect the chronicity of the hyponatremia prior to admission and its effects on long term mortality.

Methods

We designed a cohort study in adults admitted for traumatic hip fracture who had at least one serum Na performed at admission.Hyponatremic patients (HN) were divided in those with chronic prolonged (hyponatremia for 90 days or more,CPHN), and those with recent hyponatremia (hyponatremia for 30 days or less, RHN) prior to admission.

Results

1205 (76.7%) patients were normonatremic (NN) and 366 (23.3%) were HN at admission (138 ± 3 vs 132 ± 4 mmol/L Na; p <0,001). Of these, 222 (14%) had CPHN and 144 (9.1%) had RHN. Overall mortality rate was higher in CPHN 25% (56/222), followed by RHN 20% (29/144) and finally NN 14% (169/1205). Five year survival in patients with CPHN and RHN was lower than those with NN: 0.83 and 0.87 compared to 0.93 (p <0.001) figure 1. Unadjusted HR for long term mortality > in CPHN and RHN vs NN but adjusted HR was only significant for CPHN figure 2.

Conclusion

Mild chronic prolonged hyponatremia at admissionin in patients with hip fracture repair is associated with increased long term mortality.