Importance of Sodium Levels for Geriatric Patients Presented to the Emergency Department with a Simple Fall
Abstract
Abstract
Objectives: The aim of this study is to investigate the effect of plasma sodium
concentration on falls in geriatric patients age of ≥65 years who visited the
emergency room for simple falls.
Materials and Methods: The ages and
genders of the patients, plasma sodium values at presentation, localizations of
the injuries, radiological examination results (radiography and computed
tomography), classification of the injury, the presence of accompanying
fractures and whether the patient had been referred from a nursing home were
recorded and injuries were compared according to sodium levels.
Results: There was no statistically
significant difference between the location of the injuries and the presence of
hyponatremia (p=0.743). The prevalence of hyponatremia was statistically significant
in the patients who were referred from a nursing home for simple falls
(p<0.001). The increase in the incidence of vertebral and pelvic injuries as
hyponatremia became more severe was statistically significant (p<0.001).
Conclusion: Hyponatremia should be
considered as an independent risk factor for falls in patients who are ≥65
years. Hyponatremia is more common in the patients who are staying in nursing
homes.In our study, no direct relationship
between hyponatremia and fracture formation has been detected.
References
- 1. Carpenter CR, Bromley M, Caterino JM, et al. Optimal older adult emergency care: introducing multidiciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine. Acad Emerg Med 2014;21:806-9.
- 2. Kenny RA, Rubenstein LZ, Tinetti ME, et al. Summary of tye Updated American Geriatrics Society/ British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 2011;59:148-57.
- 3. Tirrell G, Sri-on J, Lipsitz LA, et al.Evaluation of older adult patients with falls in the emergency department: discordance with national guidelines.Acad Emerg Med 2015;22:461-7.
- 4. Falls among older adults: an overview.Centers for Disease Control and Prevention. Web site. Available at: http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html Accessed on September 26, 2015.
- 5. Appelman-Dijkstra NM, Papapoulos SE. Prevention of incident fractures in patients with prevalent fragility fractures: Current and future approaches. Best Pract Res Clin Rheumatol 2013;27:805-20.
- 6. Rittenhouse KJ, To T, Rogers A, et al. Hyponatremia as a fall predictor in a geriatric trauma population. Injury 2015;46:119-23.
- 7. Cumming K, Hoyle GE, Hutchison JD, et al. Prevalence, Incidence and Etiology of Hyponatremia in Elderly Patients with Fragility Fractures. J Clin Med Res 2015;7:45-51.
- 8. Muir SW, Gopaul K, Montero Odasso MM. The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. Age Ageing 2012;41:299-308.
- 9. Definition ofan older or elderly person. WHO Web site. Available at:http://www.who.int/healthinfo/survey/ageingdefnolder/en/. Accessed on May 25, 2015.
- 10. Nelson JM, Robinson MV. Hyponatremia in older adults presenting to the emergency department. Int Emerg Nurs 2012;20:251-4.
- 11. Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant 2014;40:924.
- 12. Hoorn EJ, Lindemans J, Zietse R. Development of severe hyponatraemia in hospitalized patients: treatment-related risk factors and inadequate management. Nephrology, Dialysis, Transplantation 2006;21:70–6.
- 13. Murdoch I, Turpin S, Johnston B, eds. Falls and immobility. In: Geriatric Emergencies. USA: Wiley; 2015:112-27.
- 14. Ganguli A, Mascarenhas RC, Jamshed N, et al. Hyponatremia: incidence, risk factors, and consequences in the elderly in a home-based primary care program. Clin Nephrol 2015;84:75-85.
- 15. Icme F, Becel S, Ahmedali A, et al. The use of trauma scoring systems in elderly patients who are admitted to the emergency department due to falls. Turkish Journal of geriatrics 2014;17:138-42.
- 16. Siregar P. The Risk of Hyponatremia in The Elderly Compared with Younger in The Hospital Inpatient and Outpatient. Acta Med Indones 2011;43:158-61.
- 17. Lee KH, Ha YC, Lee YK, et al. Frequency, risk factors, and prognosis of prolonged delirium in elderly patients after hip fracture surgery. Clin Ortop Relat Res 2011;469;2612-20.
- 18. Gankam Kengne F, Andres C, Sattar L, Melot C, Decaux G. Mild hyponatremia and risk of fracture in the ambulatory elderly. QJM 2008;101:583-8.
- 19. Hoorn EJ, Rivadeneira F, van Meurs JB, et al. Mild hyponatremia as a risk factor for fractures: the Rotterdam Study.Journal of Bone and Minereal Research 2011;26:1822-28.
- 20. Streubel PN, Ricci WM, Wong A, Gardner MJ. Mortality after distal femur fractures in elderly patients. Clin Orthop Relat Res 2011;469:1188-96.
- 21. Choudhury M, Aparanii K, Norkus EP, Dharmarajan TS. Hyponatremia in hospitalized nursing home residents and outcome: minimize hospitalization and keep the stay short! J Am Med Dir Assoc 2012;13:e8-9.
Abstract
Amaç: Bu çalışmanın amacı acil servise basit düşme nedeniyle başvuran 65 yaş ve üstü hastalarda serum
sodyum değeri ile düşme ilişkisini belirlemektir.
Materyal ve Metot: Hastaların yaşları, cinsiyetleri, gelişteki sodyum değerleri, yaralanma bölgeleri,
radyolojik inceleme sonuçları (düz grafi ve tomografi), yaralanmanın sınıflaması, eşlik eden kırık varlığı
ve hastanın bakım evinden gelip gelmediği kaydedildi ve yaralanmalar sodyum seviyelerine göre
karşılaştırıldı.
Bulgular: Yaralanma bölgeleri ile hiponatremi varlığı arasında anlamlı farklılık tespit edilmedi.
(p=0,743). Basit düşme ile bakımevinden gelen hastalarda hiponatremi prevalansı, bakımevinden
gelmeyen hastalara göre istatistiksel olarak anlamlı derecede yüksek bulundu (p<0,001). Hiponatremi
derinleştikçe vertebra ve pelvis yaralanmalarında anlamlı artış görüldü (p<0,001).
Sonuç: Acil servise basit düşmeyle gelen 65 yaş ve üstü hastalarda, hiponatremi düşme için bir risk
faktörü olarak göz önüne alınmalıdır. Bakımevlerinde yaşayan kişilerde hiponatremi diğer hastalara göre
daha sık görülmektedir. Çalışmamızda hiponatremi ile kırık oluşumu arasında doğrudan bir ilişki
saptanamamıştır.
References
- 1. Carpenter CR, Bromley M, Caterino JM, et al. Optimal older adult emergency care: introducing multidiciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine. Acad Emerg Med 2014;21:806-9.
- 2. Kenny RA, Rubenstein LZ, Tinetti ME, et al. Summary of tye Updated American Geriatrics Society/ British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 2011;59:148-57.
- 3. Tirrell G, Sri-on J, Lipsitz LA, et al.Evaluation of older adult patients with falls in the emergency department: discordance with national guidelines.Acad Emerg Med 2015;22:461-7.
- 4. Falls among older adults: an overview.Centers for Disease Control and Prevention. Web site. Available at: http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html Accessed on September 26, 2015.
- 5. Appelman-Dijkstra NM, Papapoulos SE. Prevention of incident fractures in patients with prevalent fragility fractures: Current and future approaches. Best Pract Res Clin Rheumatol 2013;27:805-20.
- 6. Rittenhouse KJ, To T, Rogers A, et al. Hyponatremia as a fall predictor in a geriatric trauma population. Injury 2015;46:119-23.
- 7. Cumming K, Hoyle GE, Hutchison JD, et al. Prevalence, Incidence and Etiology of Hyponatremia in Elderly Patients with Fragility Fractures. J Clin Med Res 2015;7:45-51.
- 8. Muir SW, Gopaul K, Montero Odasso MM. The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. Age Ageing 2012;41:299-308.
- 9. Definition ofan older or elderly person. WHO Web site. Available at:http://www.who.int/healthinfo/survey/ageingdefnolder/en/. Accessed on May 25, 2015.
- 10. Nelson JM, Robinson MV. Hyponatremia in older adults presenting to the emergency department. Int Emerg Nurs 2012;20:251-4.
- 11. Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant 2014;40:924.
- 12. Hoorn EJ, Lindemans J, Zietse R. Development of severe hyponatraemia in hospitalized patients: treatment-related risk factors and inadequate management. Nephrology, Dialysis, Transplantation 2006;21:70–6.
- 13. Murdoch I, Turpin S, Johnston B, eds. Falls and immobility. In: Geriatric Emergencies. USA: Wiley; 2015:112-27.
- 14. Ganguli A, Mascarenhas RC, Jamshed N, et al. Hyponatremia: incidence, risk factors, and consequences in the elderly in a home-based primary care program. Clin Nephrol 2015;84:75-85.
- 15. Icme F, Becel S, Ahmedali A, et al. The use of trauma scoring systems in elderly patients who are admitted to the emergency department due to falls. Turkish Journal of geriatrics 2014;17:138-42.
- 16. Siregar P. The Risk of Hyponatremia in The Elderly Compared with Younger in The Hospital Inpatient and Outpatient. Acta Med Indones 2011;43:158-61.
- 17. Lee KH, Ha YC, Lee YK, et al. Frequency, risk factors, and prognosis of prolonged delirium in elderly patients after hip fracture surgery. Clin Ortop Relat Res 2011;469;2612-20.
- 18. Gankam Kengne F, Andres C, Sattar L, Melot C, Decaux G. Mild hyponatremia and risk of fracture in the ambulatory elderly. QJM 2008;101:583-8.
- 19. Hoorn EJ, Rivadeneira F, van Meurs JB, et al. Mild hyponatremia as a risk factor for fractures: the Rotterdam Study.Journal of Bone and Minereal Research 2011;26:1822-28.
- 20. Streubel PN, Ricci WM, Wong A, Gardner MJ. Mortality after distal femur fractures in elderly patients. Clin Orthop Relat Res 2011;469:1188-96.
- 21. Choudhury M, Aparanii K, Norkus EP, Dharmarajan TS. Hyponatremia in hospitalized nursing home residents and outcome: minimize hospitalization and keep the stay short! J Am Med Dir Assoc 2012;13:e8-9.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 27, 2018 |
| Published in Issue | Year 2018 Volume: 18 Issue: 4 |
