Kalça kırığı nedeniyle hastaneye başvuran hastalarda yatış sırasındaki hiponatremi insidansı ve mortaliteye etkisi

Year 2023, Volume: 48 Issue: 2, 601 - 606, 02.07.2023

Kemal Kayaokay , Derya Arslan Yurtlu

https://doi.org/10.17826/cumj.1284848

Cited By: 2

Abstract

yatırılan kırılgan yaşlı hastalarda yüksek morbidite ve mortalite ile ilişkilidir. Bu çalışmada, kalça kırığı nedeniyle hastaneye başvuran yaşlı hastalarda hiponatremi insidansının, hastanede yatış süresi, hastane içi ve 1 yıllık mortalite üzerine etkilerinin araştırılması amaçlandı.
Gereç ve Yöntem: Ocak-Aralık 2020 tarihleri arasında Ortopedi Kliniğine kalça kırığı nedeniyle başvuran 65 yaş üstü hastalar retrospektif olarak incelendi. Hastaların yaşı, cinsiyeti, kırık tipi, ek hastalıkları ve ASA fiziksel durumu kaydedildi. Hastaneye yatıştaki plazma Na, K ve Ca değerleri kaydedildi. Hiponatremik ve normonatremik hastalar demografik veriler, komorbiditeler, hastanede kalış süreleri, hastane içi ve 1 yıllık mortalite oranları açısından karşılaştırıldı.
Bulgular: Toplam 253 hastanın 52 (%20,5) 'sinde hastaneye yatışta hiponatremi mevcuttu. Hiponatremik ve normonatremik hastalarda demografik veriler benzerdi. Hiponatremi grubunda ortalama Na değerleri 131,13±3,96 mmol/L idi ve normonatremi grubuna göre anlamlı derecede düşüktü (138,73±2,27). Hiponatremik hastalarda diabetes mellitus (n:23, %44) konjestif kalp yetmezliği (n:9, %17) oranları daha yüksekti. Ameliyat öncesi ve toplam hastanede yatış süresi sırasıyla 5,21±2,68 ve 9,92±4,49 gündü ve hiponatremili hastalarda anlamlı olarak daha yüksekti. Hastane içi ve 1 yıllık mortalite oranları gruplar arasında benzerdi.
Sonuç: Kalça kırığı olan hastalarda hiponatremi insidansı %20,5 olarak saptandı ve bu hastalarda hem ameliyat öncesi hem de toplam hastanede kalış süresi uzadı. Bu çalışmada mortalite oranları benzer olsa da, hastanede kalış süresinin mortaliteyi arttırdığı bilindiğinden hiponatremi bu hastalarda dikkatli takip ve erken tedavi gerektirmektedir

Keywords

hiponatremi, kalça kırığı, mortalite, hastanede kalış süresi

The incidence of hyponatremia in hospitalized patients due to hip fracture and its effect on mortality

Abstract

Purpose: Hyponatremia is associated with high morbidity and mortality in elderly patients. This study aimed to investigate the incidence of hyponatremia and its effects on the duration of hospitalization, in-hospital and 1-year mortality in elderly patients admitted to the hospital due to hip fracture.
Materials and Methods: After the approval of the ethics committee, patients over the age 65 and had hip surgery between January-December 2020 were retrospectively analyzed. The age, gender, fracture type, current comorbidities, and American Society of Anesthesiology physical status scores of the patients were recorded. Plasma Na, K, and Ca values in admission to hospital were recorded. Patients with hyponatremia and normonatremia were compared in terms of demographic data, comorbidities, duration of hospitalization, in-hospital, and 1-year mortality rates.
Results: Of the total 253 patients, 52(%20.5) had hyponatremia at hospital admission. Demographic data were similar in hyponatremic and normonatremic patients. In hyponatremia group mean Na values were 131.13±3.96 mmol/L and significantly lower than normonatremia group (138.73±2.27). In the hyponatremic group, diabetes mellitus was observed in 23 (44%) patients, and congestive heart failure was observed in 9 (17%) patients, which was higher than the normonatremic group. The preoperative and total duration of hospitalization was 5.21±2.68 and 9.92±4.49 days respectively and higher in patients with hyponatremia. In-hospital and 1-year mortality rates were similar between the groups.
Conclusion: The incidence of hyponatremia was found to be 20.5% in patients with hip fractures, and both the preoperative and total hospital stays were prolonged in these patients. Although mortality rates were similar in this study, hyponatremia requires careful follow-up and early treatment in these patients, since it is known that the length of hospital stay increases mortality.

Keywords

hyponatremia, hip fracture, mortality, length of hospital stay

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