Table 1 Hyponatremia and falls: characteristics of the studies included in the review
From: Hyponatremia and aging-related diseases: key player or innocent bystander? A systematic review
Study | Study design | Sodium level | Definition of hyponatremia used | Timing of sodium measurement | Participants (number) | Age of participants (years) | Gender | Etiology of hyponatremia | Scores | Diuretics | Main outcomes |
|---|---|---|---|---|---|---|---|---|---|---|---|
Renneboog et al. (2006) [9] | Case control | 125 ± 5 mEq/l (mean ± SD) in hyponatremia group | Serum sodium  < 132 mEq/l | At admission and after 72-h intervals | 366 | 70 (14) Mean (SD) | 56.56% F | SIADH, diuretic-induced hyponatremia, salt depletion, polydipsia-hyponatremia syndrome, tubulopathy, transient SIADH | TTW | Type and dosage of diuretic not specified | Incidence of falls in MED |
Hoorn et al. (2011) [4] | Prospective cohort | 133.4 ± 2.0 mEq/l (total mean ± SD) | Serum sodium < 136 mEq/l | Single at baseline | 5208 | 70.3 (9.1) Mean (SD) | 61.5% F | Not evaluated | - | Thiazides, loop diuretics, potassium-sparing diuretics. Dosage not reported | Incidence of fractures, falls, mortality in the community |
Gosch et al. (2012) [13] | Case control | 127.98 mEq/l (mean) in hyponatremia group | Serum sodium  < 135 mEq/l | Single at admission | 2880 | 78.6 (6.98) Mean (SD) | 75.6% F | Hypo- (4.7%), and normo-osmolar (1.6%) hyponatremia, adverse drug reaction (15.5%), hyponatremia related to heart failure (3.1%), severe liver disease (0.8%), cancer (1.6%), adrenal insufficiency (1.6%), SIADH (0.8%) | CCI, CIRS, ADL, TMT, TUG | Type and dosage of diuretic not specified | Effect of hyponatremia on CGA in patients admitted to the GEMU |
Ahamed et al. (2014) [28] | Case control | Not reported | Serum sodium  ≤ 134 mE/l | Single at admission | 486 | 80.8 (7.63) Mean (SD) | 59.3% F | Not evaluated | CCI | Type and dosage of diuretic not specified | Incidence of falls in hyponatremic patients admitted under GIMU |
Ganguli et al. (2015) [29] | Retrospective chart review | 131.2 ± 4.5 mEq/l (initial hyponatremia) 130.4 ± 3.5 mEq/l (persistent hyponatremia) | Serum sodium  < 136 mEq/l | At baseline, at least 2 or more than 6 consecutive measurements | 608 | 84.3 (9.3) Mean (SD) | 77.1% F | Euvolemic (69.8%): main causes were thiazides and SSRI use, idiopathic SIADH; hypervolemic (9.4%): main cause was end-stage renal disease and congestive heart failure; hypovolemic (20.7%): main causes were diarrhea and diuretics (furosemide and thiazide) | CCI | Thiazides, furosemide. Dosage not reported | Incidence of falls, fractures dues to falls, hospitalization, mortality in community-dwelling elderly |
Rittenhouse et al. (2015) [30] | Cross-sectional | 138 mEq/l (total median) | Serum sodium  < 135 mEq/l | Single at admission | 2370 | 80 (74–86) Median (IQR) | 60.1% F | Not evaluated | - | Not evaluated | Prevalence of hyponatremia in fallers and mortality in patient admitted to level 2 geriatric trauma center |
Tachi et al. (2015) [31] | Cross-sectional | 132 mEq/l (median) in hyponatremia group | Serum sodium  < 135 mEq/l | Single at admission | 2948 | 64.5% aged 65 years old or older | 41.1% F | Not evaluated | - | Type and dosage of diuretic not specified | Prevalence of hyponatremia in hospitalized patients and effect on the risk of falls |
Harianto et al. (2017) [32] | Case control | Not reported | Serum sodium  < 134 mEq/l | Single at admission | 261 | 82.85 (7.06) Mean (SD) | 41.4% F | Not evaluated | - | Type and dosage of diuretic not specified | Prevalence of hyponatremia and incidence of falls in in-hospital patients |
Kuo et al. (2017) [33] | Cross-sectional | 130.5 ± 4.1 mEq/l (hyponatremic patients > 65 years old) | Serum sodium  < 135 mEq/l | Single at admission | 2494 |  ≥ 65 years old (= elderly) 20–64 years old (= adult) | 63.2% F | Not evaluated | - | Not evaluated | Prevalence of hyponatremia in fallers, mortality in patients admitted to level 1 trauma center |
Hosseini et al. (2018) [34] | Prospective cohort | 140 ± 2.3 mEq/l (mean ± SD) in falls group | Serum sodium  ≤ 137 mEq/l | Single at baseline | 1113 | 68.6 (6.8) Mean (SD) | 44.1%F | Not evaluated | ADL, BBS | Patient under thiazides were excluded. Dosage not reported | Incidence of bone fracture and falls |
Boyer et al. (2019) [35] | Cross-sectional | Not reported | Serum sodium  < 136 mEq/l | Single at admission | 696 | 86.1 (5.6) Mean (SD) | 63.1% F | Not evaluated | CGA, ADL, SEGA | Type and dosage of diuretic not specified | Prevalence of mild chronic hyponatremia in fallers and not fallers admitted to the MUPA unit |