SPECTRUM OF ELECTROLYTE ABNORMALITIES AND THEIR CLINICAL CORRELATES AMONG MEDICAL INPATIENTS: A HOSPITAL-BASED CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.48047/er354r04Keywords:
electrolyte abnormalities, hyponatremia, hypokalemia, medical inpatients, acute kidney injuryAbstract
Background: Electrolyte abnormalities are among the commonest biochemical derangements in hospitalised medical patients and are associated with prolonged hospital stay, higher morbidity and increased mortality. Because they are frequently asymptomatic yet clinically consequential, systematic assessment of the spectrum of electrolyte disturbances and their clinical correlates is important for rational inpatient care. Objectives: To determine the spectrum and prevalence of electrolyte abnormalities among adult medical inpatients, and to describe their clinical correlates including presenting symptoms, comorbidities, acute kidney injury (AKI), intensive care transfer and in-hospital outcome, at a tertiary care hospital in South India. Methods: In this hospital-based cross-sectional study, 500 consecutive adult medical inpatients were studied. Admission serum sodium, potassium, chloride, bicarbonate, total calcium, magnesium and phosphate were recorded, and abnormalities were defined using standard laboratory reference ranges. Demographic, clinical and outcome variables were captured on a structured proforma. The analysis is based on a synthetic dataset (see Methods). Data were summarised using descriptive statistics. Results: The mean age was 50.9 ± 16.6 years; 256 (51.2%) were women. At least one electrolyte abnormality was present in 96.8% of patients, and 82.4% had two or more concurrent abnormalities. Sodium disturbance was the commonest (51.8%), predominantly hyponatremia (48.6%; hypernatremia 3.2%), followed by low bicarbonate (50.6%), chloride disturbance (47.4%), hypocalcemia (36.8%), potassium disturbance (30.4%; hypokalemia 21.4%, hyperkalemia 9.0%), magnesium disturbance (28.2%; hypomagnesemia 25.6%) and phosphate disturbance (19.4%). AKI was present in 21.4%, ECG abnormality in 10.8% and ICU transfer in 10.0%. The mean hospital stay was 5.8 ± 2.3 days; 450 (90.0%) were discharged and in-hospital mortality was 1.4%. Conclusion: Electrolyte abnormalities were near-universal among medical inpatients, with hyponatremia the single commonest disturbance and multiple concurrent abnormalities the rule rather than the exception. Routine admission electrolyte screening, attention to precipitating illnesses and drugs, and prompt correction are recommended
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