Incidence and clinical significance of abnormalities in potassium, sodium and calcium levels in elderly patients with hip fractures during the perioperative period

Objective: This study aims to investigate the incidence and clinical significance of sodium, potassium and calcium electrolyte disturbances in elderly patients with hip fracture before an operation.

Methods: The clinical data of 220 patients with intertrochanteric fracture and 261 patients with femoral neck fracture from September 2013 to December 2016 in our hospital (≥60 years old) was reviewed. The sodium, potassium and calcium values, and the underlying diseases of patients were recorded after the first blood test. These patients were divided into two groups according to the fracture site: femoral neck fracture group and intertrochanteric fracture group. Then, the differences between these two groups were compared to analyze the proportion of electrolyte disturbances in elderly patients with hip fracture, and explore its clinical significance.

Results: Patients with intertrochanteric fractures were older than patients with femoral neck fracture. There was no significant difference in the prevalence of underlying diseases between these two groups. The incidence of hyponatremia, hypokalemia and hypocalcemia was 10.0%, 32.9% and 1.4%, respectively, in the femoral neck fracture group, and 24.3%, 21.1% and 7.7%, respectively, in the intertrochanteric fracture group. The incidence of hypernatremia, hyperkalemia and hypercalcemia was 1.4%, 1.4% and 0.9%, respectively, in the femoral neck fracture group, and 1.1%, 0.7% and 0.8%, respectively, in the intertrochanteric fracture group.

Conclusion: Patients with old hip fractures before an operation are prone to hyponatremia, hypokalemia and hypocalcemia, and most of them have mild electrolyte disorders, which needs to be corrected in time. Furthermore, some patients urgently need urgent supplementation ofblood electrolytes for some diseases, the correction of electrolyte disorders, and the prevention of serious adverse consequences.

Key words: Femoral neck fracture, Femoral intertrochanteric fracture, Hyponatremia, Hypokalemia, Hypocalcemia.