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Abstract

Introduction: Approximately one in three older adults falls each year, resulting in a significant proportion of geriatric traumatic injuries. In a hospital with a focus on geriatric fall prevention, we sought to characterize this population to develop targeted interventions. As mild Hyponatremia (HN), defined as a serum Na+ <135meq/L, has been reported to be associated with falls, unsteadiness and attention deficits, we hypothesized that HN is associated with falls in our geriatric trauma population. Methods: In a PA-verified Level II trauma center Geriatric (age ≥65) trauma admissions from 2008-2011 were queried. Univariate analyses of HN (Na<135meq/L), gender, age 65-84 vs. age >84, mortality, ISS and RTS were conducted. Variables significantly associated with falls were subsequently incorporated into a multivariate logistic regression model. p<0.05 was significant. Results: Of a total of 8,169 trauma admissions from 2008-2011, 2,370 (29.0%) were geriatric trauma admissions. There were 1,841 (77.7%) geriatric patients who had a fall as their mechanism of injury, 253 (13.7%) of which were Hyponatremic. Univariate analysis of demographic factors demonstrated no significant difference in mortality, ISS, or RTS between the fall and no fall groups. Gender and age (65-84 vs. ≥85) were found to be significantly different between the two groups (p<0.001), with the fall group having a larger proportion of females and patients age 85 and older. After adjusting for age and gender, patients with HN were found to be at an increased odds of falling (OR 1.80; 95% CI 1.26-2.58; p=0.001) as compared with patients without HN. Conclusions: Patients who have mild Hyponatremia have 80% higher odds of falling, when adjusting for age and gender. Consequently, Hyponatremia identification and management should be an integral part of any geriatric trauma fall prevention program. Additionally, if HN is found during a geriatric fall workup, it should be corrected prior to discharge and closely followed by a primary care physician to prevent recurrent episodes of falls.