Unrecognised Post-Operative Hyponatraemia in the Elderly with Hip Fractures

Abstract

Inappropriate fluid therapy and surgical stress further decrease renal ability to excrete water. This results in hyponatraemia in the elderly, who tend to have a precarious homeostatic equilibrium. There is a high incidence of post-operative hyponatraemia in elderly patients undergoing surgery. We scrutinised biochemistry records, notes and fluid charts in 227 patients who had undergone treatment for hip fractures. Patients with a possible medical cause for hyponatraemia (25) were excluded. The group of 202 patients had an average age of 77.8 years. We noted an incidence of 17.8% of mild hyponatraemia and 4.4% of severe hyponatraemia.

A high index of clinical suspicion and sound knowledge of fluid balance can prevent this potentially serious complication.