{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T14:21:54Z","timestamp":1793283714122,"version":"4.5.0"},"reference-count":57,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,7,12]],"date-time":"2018-07-12T00:00:00Z","timestamp":1531353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To perform a meta\u2010analysis based on published studies that compared falls and bone fractures between patients with and without hyponatremia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Context<\/jats:title><jats:p>There is evidence suggesting that hyponatremia is associated with an increased risk of falls and bone fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>An extensive Medline, Embase and Cochrane search was performed to retrieve all studies published up to, 30 April 2017, using the following words: \u201chyponatremia\u201d or \u201chyponatraemia\u201d <jats:styled-content style=\"fixed-case\">AND<\/jats:styled-content> \u201cfalls\u201d and \u201cbone fractures.\u201d A meta\u2010analysis was performed including all studies comparing falls and bone fractures in subjects with or without hyponatremia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Results<\/jats:title><jats:p>Of 216 retrieved articles, 15 studies satisfied inclusion criteria encompassing a total of 51\u00a0879 patients, of whom 2329 were hyponatremic. Across all studies, hyponatremia was associated with a significantly increased risk of falls (<jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.14[1.71; 2.67]. This result was confirmed when only hospitalized patients were considered (<jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.44 [1.97; 3.02]). A meta\u2010regression analysis showed that the hyponatremia\u2010related risk of falls was higher in those studies considering a lower serum [Na<jats:sup>+<\/jats:sup>] cut\u2010off to define hyponatremia. Interestingly, the estimated risk of falls related to hyponatremia was already significantly higher when a serum [Na<jats:sup>+<\/jats:sup>] cut\u2010off of 135\u00a0mmol\/L was considered (<jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.26[1.23;1.29]). The presence of hyponatremia was also associated with a higher risk of fractures, particularly hip fractures (<jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.00[1.43;2.81]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study confirms that hyponatremia is associated with an increased risk of falls and bone fractures. The clinical, social and economic relevance of such association is strengthened by the increased incidence of hyponatremia in older people.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13790","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T19:02:51Z","timestamp":1529434971000},"page":"505-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Hyponatremia, falls and bone fractures: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"89","author":[{"given":"Giovanni","family":"Corona","sequence":"first","affiliation":[{"name":"Endocrinology Unit Maggiore\u2010Bellaria Hospital  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Norello","sequence":"additional","affiliation":[{"name":"Endocrine Unit Department of Experimental and Clinical Biomedical Sciences \u201cMario Serio\u201d \u201cCenter for Research, 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