Abstract
Introduction: Electrolyte imbalance in the elderly is a clinical problem faced by both elderly care physicians and orthopaedic surgeons alike. The abnormalities in homeostatic mechanisms that manifest with age can have dramatic consequences for the unwary clinician. This study aims to establish the incidence of hyponatraemia within an orthopaedic population and to determine whether this is different to a control group of elderly care patients.
Methods: Retrospective, consecutive analysis of serum sodium levels of 200 patients (100 hip fracture patients and a control group of 100 elderly care patients). Serum sodium levels on admission and during the inpatient stay were recorded and analysed using student’s t-tests to establish the incidence of hyponatraemia, changes in serum sodium level during admission and differences between the two groups.
Results: Hyponatraemia was evident in a third of all admissions (Orthopaedic: 29%; Elderly Care: 33%). The admission sodium level for both groups was not statistically different (t (198) =0.70, p=0.49). There was no significant difference in the observed hyponatraemia between the two populations throughout their care in hospital (t (198) =0.64, p=0.52).
Discussion: While there is a high incidence of hyponatraemia within the elderly population, there is no difference in its incidence between the aged orthopaedic population and the general elderly population. This is seen on admission and is also shown to be independent of operative procedures and fluid management as in-patients. Clinicians must be aware of the innocuous symptoms that may herald the catastrophic and avoidable consequences of this condition.
The abstracts were prepared by Major SA Adams. Correspondence should be addressed to Major M Butler, CSOS, Institute of Naval Medicine, Crescent Road, Alverstoke, Hants PO12 2DL
