Spectrum of Electrolyte Abnormalities and their Association with Mortality and Intensive Care Unit Outcomes in Critically Ill Patients: A Prospective Observational Study

Abstract

Introduction: Electrolyte disturbances are common in critically ill patients and may adversely affect cardiac conduction, neuromuscular function, and acid–base balance. These abnormalities may reflect disease severity and are associated with poor intensive care unit (ICU) outcome and increased mortality. This study aimed to determine the spectrum of electrolyte imbalances among critically ill patients and assess their association with mortality. Methodology: After obtaining approval from the Institutional Ethics Committee, a hospital-based, prospective study was carried out in the Department of Respiratory Medicine, Gouri Devi Institute of Medical Sciences and Hospital over a period of 3 months, including 123 adult ICU patients. Serum sodium and potassium levels obtained within the first 24 h were measured by the ion-selective electrode method, and clinical outcomes were recorded using a structured case record form. Results: A total of 123 critically ill patients were included. Hyponatremia was the most common electrolyte abnormality (29.3%), followed by hypokalemia (12.2%), hypernatremia (10.6%), and hyperkalemia (9.8%). Overall ICU mortality was 33.3% (41/123) and was higher among patients with electrolyte abnormalities than those with normal electrolyte levels, with the highest mortality observed in hypernatremia (46.2%) and hypokalemia (53.3%). Conclusion: Electrolyte imbalances are common in critically ill ICU patients, and routine monitoring and appropriate management of electrolyte abnormalities are important.