Table 3.
Association between hyponatremia, falls and fractures in the elderly patients
| Author | Study design | Mean serum Na in HyNa group | N | Outcome |
|---|---|---|---|---|
| Ayus and Arieff [22] | Prospective study of postmenopausal women with chronic symptomatic HyNa (Na <130 mmol/L) | 111 ± 12 | 53 | 19% presented with orthopedic injury. |
| McPherson and Dunsmuir [26] | Retrospective study; incidence of moderate HyNa (Na <130 mmol/L) in patients with hip fractures. | N/A | 107 | 2.8% incidence of HyNa at presentation. |
| Renneboog et al. [30] | Case–control study; prevalence of falls in patients with chronic asymptomatic HyNa (Na <133 mmol/L) versus normonatremic controls. | 126 ± 5 | 244 | 21.3% incidence of falls in HyNa group versus 5.3% controls. |
| Renneboog et al. [30] | Prospective study evaluating gait disorders in patients with chronic asymptomatic HyNa (Na <132 mmol/L). | 128 ± 3 | 16 | Significant disorders in gait and attention. |
| Gankam Kengne et al. [23] | Case–control study; prevalence of HyNa in elderly patients (>65 years) presenting with and without bone fracture. | 131 ± 3 | 1026 | 13% incidence of HyNa in fracture patients versus 3.9% in controls. |
| Sandhu et al. [24] | Case-control study comparing the incidence of mild HyNa (Na <135 mmol/L) in elderly patients (>65 years) with and without large bone fracture. | 131 ± 2 | 728 | 9.1% incidence of HyNa in patients with fractures versus 4.1% in controls. |
| Verbalis et al. [33] | Cross-sectional cohort study; evaluation of BMD in patients >50 years with HyNa (Na <135 mmol/L) versus normonatremic controls in the NHANES III | 133 ± 2 | N/A | Adjusted OR of osteoporosis in HyNa adults was 2.87 times that among controls. |
| Kinsella et al. [27] | Cross-sectional cohort study; incidence of HyNa (Na <135 mmol/L) in women with and without a fracture who underwent previous bone densitometry measurement. | 132.2 ± 1.8 | 1408 | 8.7% incidence of HyNa in women with fracture versus 3.2% in those without. |
| Hoorn et al. [28] | Cross-sectional cohort study; incidence of falls and fractures in an elderly population with and without HyNa (Na <136 mmol/L) | 133.4 ± 2 | 5208 | 23.8% incidence of falls in HyNa versus 16.4% in those without. OR of V/non-V fracture in HyNa 1.39 and 1.78, respectively. |
| Tolouian et al. [25] | Case–control study; patients admitted for hip fracture secondary to fall compared to patients admitted for elective hip or knee replacement | 131 ± 2 | 249 | Prevalence of HyNa 16.9% in cases versus 4.65 in controls (P = 0.03). OR = 4.80;P = 0.04 |
HyNa: hyponatremic; V/non V: vertebral and non-vertebral.