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- 저자 : ( Juan Carlos Ayus ) (검색결과 1 건)
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( Nora Angelica Fuentes ),( Diego Hernan Giunta ),( Cristina Maria Elizondo ),( Fernan Gonzalez Bernaldo De Quiros ),( Gabriel Dario Waisman ),( Juan Carlos Ayus ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Hip Fracture (HF) is a leading cause of morbidity and mortality in elderly. Related complications are cardiovascular (CVD), sepsis and venous thromboembolism (VTE), deep venous thrombosis (DVT) and pulmonary embolism (PE). In recent studies, chronic hyponatremia was observed to be an independent risk factor for hip fracture, nevertheless there is no evidence on prognosis of these patients compared to patients without hyponatremia. Objective: To compare the prognosis and complications of HF in normonatremic patients (N) and hyponatremic patients (H). Methods: Retrospective cohort of hospitalized patients with HF, followed up to 30 days after diagnosis, at Hospital Italiano of Buenos Aires. Presence of complications (sepsis, DVT, PE, and CVD), hospital length of stay, mortality and readmission were evaluated. Results: 1571 patients were included, 76, 7% (1205) for N and 23, 3% (366) for H. Most patients were female, 82. 5% and 79. 8% for H and N respectively. H were older, 85 vs. 82 years (p<0. 001). Sepsis was the most frequent complication for H (OR 1. 7, 95% CI: 1. 13-2. 6). Length of stay was 7 days vs. 8 days (p=0. 053) for N and H. Readmissions were 12. 9% for N vs. 15. 8% for H (p=0. 14). Hospital mortality was minor for N than for H (14. 7% vs. 19. 9%; p=0. 016), crude OR was 1. 45 (1. 07-1. 96) and adjusted OR was 1. 15 (0. 84-1. 6). Survival was higher for N than for H (p<0. 001). Crude hazard ratio (HR) of death for H compared to N was 1. 8 (1. 4-2. 35) and adjusted HR was 1. 45 (1. 1-1. 9). Conclusions: Hyponatremic patients have higher risk of sepsis, hospital length of stay and mortality. Thus hyponatremia could represent a marker of severity of underlying diseases or be a consequence of treatments during the surgical procedures, it could serve as alert for potential risk on outcome of these patients.
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