ArticlePloS one2014
Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed, 102 citations in OpenAlex.
- The Truth Lies Within the Gap.EJIFCC · 2026Article
- Hyponatraemia in Neck of Femur Fracture: A Narrative Review of Epidemiology, Pathophysiology, and Outcomes.Geriatrics (Basel, Switzerland) · 2026Review
- Preoperative hyponatremia is associated with increased postoperative complications and short- to long-term mortality in geriatric hip fracture patients: a retrospective cohort study.BMC geriatrics · 2026Article
- Article
- An Instant Relationship Between Hyponatremia, Geriatric Syndromes, and Drugs in Older Adults: A Cross-Sectional Analysis from a Single Geriatric Clinic.Diagnostics (Basel, Switzerland) · 2025Article
- Serum sodium levels and geriatric syndromes: an overlooked association.European geriatric medicine · 2025Article
- Key Considerations for Frail Patients Undergoing Hip Fracture Surgery.Clinics and practice · 2024Review
- Short-Term Outcomes of Patients With Hyponatremia Presenting to the Emergency Department: An Observational Study.Cureus · 2024Article
- Review
- Article
- Association of hyponatremia with bone mineral density and fractures: a narrative review.Therapeutic advances in endocrinology and metabolism · 2023Review
- Influence of Hyponatremia on Spinal Bone Quality and Fractures Due to Low-Energy Trauma.Medicina (Kaunas, Lithuania) · 2021Article
- A rare report of obstructive nephropathy induced hyponatremia.Journal of community hospital internal medicine perspectives · 2021Article
- Association between serum sodium level within normal range and handgrip strength in relation to hypertension status: a cross-sectional study.Scientific reports · 2021Article
- Fluid Intake Recommendation Considering the Physiological Adaptations of Adults Over 65 Years: A Critical Review.Nutrients · 2020Review
- Hypotheses about sub-optimal hydration in the weeks before coronavirus disease (COVID-19) as a risk factor for dying from COVID-19.Medical hypotheses · 2020Article
- [Hyponatremia in older persons (part I)-keep diagnosis simple : How to detect tricks and avoid pitfalls].Zeitschrift fur Gerontologie und Geriatrie · 2020Article
- Omeprazole-induced and pantoprazole-induced asymptomatic hyponatremia: a case report.Journal of medical case reports · 2020Article
- Chronic hyponatremia in patients with proximal femoral fractures after low energy trauma: A retrospective study in a level-1 trauma center.Bone reports · 2020Article
- Do Hyponatremia or Its Underlying Mechanisms Associate With Mortality Risk in Observational Data?Critical care explorations · 2020Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHyponatremia (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.
methodsProspective 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.
results127/212 (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%).
conclusionHyponatremia 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.
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