Association between electrolyte imbalance and mortality in older adults with hip fracture

Hip fractures in the elderly are associated with high mortality rates. This study aimed to evaluate whether hyponatremia, hypernatremia, hypokalemia, and hyperkalemia are associated with 90-day postoperative mortality after hip fracture surgery. We retrospectively analyzed data from 388 patients who underwent surgery for hip fracture between January 1, 2020, and July 1, 2025, and were included in the study. Patient age, gender, American Society of Anesthesiologists (ASA) grade, fracture type, time from hospital admission to surgery, length of hospital stay, and sodium and potassium levels during hospitalization were recorded. Hyponatremia (p=0.02), hypernatremia (p=0.04), hypokalemia (p=0.03), and hyperkalemia (p=0.04) were found to be associated with 90-day mortality after hip fracture. This association persisted even after adjusting for age, sex, ASA, fracture type, time from hospital admission to surgery, and length of hospital stay. Hyponatremia, hypernatremia, hypokalemia, and hyperkalemia are common preoperative and postoperative findings in elderly patients undergoing hip fracture surgery and have been shown to be associated with mortality within 90 days postoperatively.