Hyperchloremia at hospital admission for hip fractures is associated with increased morbidity and mortality rates.

BACKGROUND

Hip fractures in the elderly represent a major public health concern due to their high incidence, associated morbidity and mortality, and rising healthcare costs. This study investigates the impact of initial serum chloride levels, measured upon emergency department admission, on hospital length of stay, revision surgeries, and in-hospital mortality in elderly patients with hip fractures.

METHODS

Between August 2022 and August 2023, a total of 204 patients over 65 years of age diagnosed with hip fractures in the emergency department were included in the study. Patients were categorized into two groups based on their initial serum chloride levels: normochloremic (96-108 mEq/L) and hyperchloremic (>115 mEq/L). Length of hospital stay and postoperative complications were compared between the groups.

RESULTS

The mean chloride level was 102.1 mEq/L in the normochloremic group and 121.3 mEq/L in the hyperchloremic group. The average hospital length of stay was 9.9 days in the normochloremic group and 15.5 days in the hyperchloremic group, a statistically significant difference (p=0.009). Mortality and revision surgery rates did not show statistically significant differences between the groups. However, all six patients who died during the study had serum chloride levels above 115 mEq/L at admission.

CONCLUSION

This study demonstrates that elevated serum chloride levels at admission are associated with prolonged hospital stays and increased morbidity in elderly patients with hip fractures. While hyperchloremia may not directly predict mortality or the need for revision surgery, it may serve as a prognostic marker for extended hospitalization, indicating a higher risk in this vulnerable population.