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Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures

Cumming, Kirsten ; Hoyle, Graeme E ; Hutchison, James D ; Soiza, Roy L Quinn, Terence J.

PloS one, 2014-02, Vol.9 (2), p.e88272-e88272 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures
Autor: Cumming, Kirsten ; Hoyle, Graeme E ; Hutchison, James D ; Soiza, Roy L
Quinn, Terence J.
Assuntos: Accidental falls ; Adults ; Age Factors ; Aged ; Aged patients ; Aged, 80 and over ; Antidepressants ; Causes and theories of causation ; Clinical outcomes ; Dehydration ; Development and progression ; Diseases ; Diuretics ; Edema ; Elderly patients ; Electrolytes ; Epidemiology ; Etiology ; Etiology (Medicine) ; Falls (Accidents) ; Female ; Fractures ; Fractures (Injuries) ; Fractures, Bone - complications ; Fractures, Bone - epidemiology ; Fragility ; Geriatrics ; Health aspects ; Hospitals ; Humans ; Hyponatremia ; Hyponatremia - complications ; Hyponatremia - epidemiology ; Hyponatremia - etiology ; Incidence ; Inhibitors ; Institutionalization ; Male ; Medicine ; Mortality ; Older people ; Patients ; Prevalence ; Prevalence studies (Epidemiology) ; Prospective Studies ; Proton pump inhibitors ; Sodium ; Substance abuse treatment ; Trauma
É parte de: PloS one, 2014-02, Vol.9 (2), p.e88272-e88272
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: RLS. Performed the experiments: KC GEH JDH RLS. Analyzed the data: KC RLS. Contributed reagents/materials/analysis tools: JDH RLS. Wrote the paper: KC GEH JDH RLS.
Descrição: Hyponatremia (serum sodium<135 mMol/L) is the commonest electrolyte imbalance encountered in clinical practice. It is associated with multiple poor clinical outcomes including increased mortality, longer hospital stay, falls and fractures. Prevalence is higher in frail patient groups, and elderly patients with fragility fractures (EPFF) are particularly susceptible. Euvolemic hyponatremia due to syndrome of inappropriate anti-diuretic hormone (SIADH) is widely assumed to be the commonest cause. However, little is known about the epidemiology and etiology of hyponatremia in EPFF. This study established prevalence, incidence and etiology of hyponatremia in EPFF. Prospective observational study of consenting adults aged ≥65 years admitted with a fragility fracture to a university hospital between 7th January and 4th April 2013. Prevalence of hyponatremia on admission and incidence of cases developing in hospital were reported. Etiology of cases of hyponatremia was determined by consensus of an expert panel using pre-specified data collected daily. 127/212 (60%) EPFF were recruited (mean age 79 yrs, 78% female). Two participants withdrew mid-study. Of those not recruited, 66 had incapacity to consent and 19 refused participation. Point prevalence of hyponatremia on admission was 13.4% and a further 12.6% developed hyponatremia during admission. Hypovolemic hyponatremia was predominant (70%). 73% of cases were multi-factorial in etiology. The commonest potentially causative factors in cases of hyponatremia were thiazide diuretics (76%), dehydration (70%), proton pump inhibitors (70%), SIADH (27%) and mirtazapine (15%). Hyponatremia is highly prevalent in EPFF, seen in 26% of cases. Dehydration and prescription of thiazide diuretics and proton pump inhibitors were the commonest potentially causative factors, not SIADH.
Editor: United States: Public Library of Science
Idioma: Inglês

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Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures

Cumming, Kirsten ; Hoyle, Graeme E ; Hutchison, James D ; Soiza, Roy L Quinn, Terence J.

United States: Public Library of Science

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