ArticleBMJ open2017
Associations between hyponatraemia, volume depletion and the risk of falls in US hospitalised patients: a case-control study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- A novel multistep approach to standardize the reported risk factors for in-hospital falls: a proof-of-concept study.Frontiers in public health · 2024Pooled it
- Hyponatremia and aging-related diseases: key player or innocent bystander? A systematic review.Systematic reviews · 2023Pooled it
- Hyponatraemia in ageing.Nature reviews. Endocrinology · 2025Review
- Laboratory frailty index improves prediction of in-hospital falls among older adults.Aging clinical and experimental research · 2025Article
- Effectiveness of an Early Intervention in Mild Hyponatremia to Prevent Accidental Falls in Hospitalized Older Adults-A Crossover Ecological Clinical Trial.Healthcare (Basel, Switzerland) · 2025Article
- Characteristics, management and outcomes of patients with hyponatraemia presenting to an Irish tertiary hospital.Endocrine connections · 2025Article
- Hyponatremia in geriatric patients.Zeitschrift fur Gerontologie und Geriatrie · 2025Article
- Does hyponatremia pose a risk factor for hip fractures in the elderly? Can a primary physician prevent it?Journal of family medicine and primary care · 2023Article
- Diuretics, SGLT2 inhibitors and falls in older heart failure patients: to prescribe or to deprescribe? A clinical review.European geriatric medicine · 2023Review
- Article
- Fall incidents in nursing home residents: development of a predictive clinical rule (FINDER).BMJ open · 2021Observational
- Fall predictors beyond fall risk assessment tool items for acute hospitalized older adults: a matched case-control study.Scientific reports · 2021Article
- Anxiolytic treatment but not anxiety itself causes hyponatremia among anxious patients.Medicine · 2019Observational
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveWe aimed to determine if abnormal laboratory values which may indicate volume depletion are associated with increased odds of experiencing a hospital-acquired fall.
designMatched case-control study.
settingFour hospitals located in the Southeast USA.
participantsData from 699 adult fallers and 1189 matched controls (non-fallers) were collected via chart review from 2005 to 2010. Controls were matched to cases by nursing unit, time of fall and length of stay. OUTCOME MEASURES: The primary exposures included serum sodium, blood urea nitrogen (BUN), creatinine, BUN/creatinine ratio and haematocrit. Conditional logistic regression with m:n matching was used to determine adjusted and unadjusted ORs.
resultsSerum sodium levels were strongly associated with falls. In models controlling for demographic and other fall risk factors, patients with serum sodium levels of 125 mEq/L or less were associated with increased odds of experiencing a fall as compared with those with serum sodium levels of greater than 134 mEq/L (adjusted OR (aOR)=5.08, 95% CI 1.43 to 18.08). Conversely, elevated BUN, creatinine and elevated BUN/creatinine ratios were not associated with increased odds of experiencing a fall (aOR=0.64, 95% CI 0.49 to 0.84; aOR=0.70, 95% CI 0.54 to 0.92 and aOR=0.77, 95% CI 0.58 to 1.04, respectively.)
conclusionsLaboratory indices that may indicate volume depletion appear to be unrelated to falls. However, hyponatraemia does appear to be a risk factor for falls, and those with serum sodium levels below 126 mEq/L are at especially high risk. It may be that other deficits associated with hyponatraemia, like altered mental status, are associated with risk of experiencing a hospital-acquired fall. These results indicate that abnormal laboratory values, like low sodium, can be useful for identifying hospitalised patients at risk of falling. Therefore, further investigation into abnormal laboratory values as predictors of hospital-acquired falls is warranted.
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