General characteristics of patients with electrolyte imbalance admitted to emergency department

doi:10.5847/wjem.j.issn.1920-8642.2013.02.005

Abstract

Abstract:

BACKGROUND: Fluid and electrolyte balance is a key concept to understand for maintaining homeostasis, and for a successful treatment of many metabolic disorders. There are various regulating mechanisms for the equilibrium of electrolytes in organisms. Disorders of these mechanisms result in electrolyte imbalances that may be life-threatening clinical conditions. In this study we defined the electrolyte imbalance characteristics of patients admitted to our emergency department.
METHODS: This study was conducted in the Emergency Department (ED) of Uludag University Faculty of Medicine, and included 996 patients over 18 years of age. All patients had electrolyte imbalance, with various etiologies other than traumatic origin. Demographic and clinical parameters were collected after obtaining informed consent from the patients. The ethical committee of the university approved this study.
RESULTS: The mean age of the patients was 59.28±16.79, and 55% of the patients were male. The common symptoms of the patients were dyspnea (14.7%), fever (13.7%), and systemic deterioration (11.9%); but the most and least frequent electrolyte imbalances were hyponatremia and hypermagnesemia, respectively. Most frequent findings in physical examination were confusion (14%), edema (10%) and rales (9%); and most frequent pathological findings in ECG were tachycardia in 24%, and atrial fibrillation in 7% of the patients. Most frequent comorbidity was malignancy (39%). Most frequent diagnoses in the patients were sepsis (11%), pneumonia (9%), and acute renal failure (7%).
CONCLUSIONS: Electrolyte imbalances are of particular importance in the treatment of ED patients. Therefore, ED physicians must be acknowledged of their fluid-electrolyte balance dynamics and general characteristics.

Key words: Emergency department, Electrolyte imbalance, Patient characteristics

Arif Kadri Balcı, Ozlem Koksal, Ataman Kose, Erol Armagan, Fatma Ozdemir, Taylan Inal, Nuran Oner. General characteristics of patients with electrolyte imbalance admitted to emergency department[J]. World Journal of Emergency Medicine, 2013, 4(2): 113-116.

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Electrolytes	Imbalance	Number of patients	%
Na⁺	Hyponatremia	600	60
	Hypernatremia	52	5
K⁺	Hypokalemia	152	15
	Hyperkalemia	80	8
Ca⁺⁺	Hypocalcemia	512	51
	Hypercalcemia	38	4
Mg⁺⁺	Hypomagnesemia	52	5
	Hypermagnesemia	10	1

Variables	Number of patients	%
Symptoms
Dyspnea	146	14.7
Fever	136	13.7
Systemic deterioration	118	11.9
Abdominal pain	98	9.8
Weakness	94	9.4
Angina pectoris	38	3.8
Vomiting	36	3.6
Syncope	31	3.1
Diarrhea	28	2.8
Findings in physical examinations
Confusion	141	14
Edema	100	10
Ral	90	9
Oliguria-anuria	64	6
Defense	44	4
Paresis	42	4
Ronchi	38	4
Ascites	28	3
Icterus	22	2
ECG patterns
Normal sinus rhythm	613	62
Tachycardia	236	24
Atrial fibrillation	68	7
Atrioventricular block	36	4
Bradycardia	18	2
Spiked T	12	1
ST segment change	12	1
Comorbidities
Malignancy	367	39
Hypertension	301	30
Diabetes mellitus	203	20
Coroner artery disease	130	13
Chronic renal failure	98	10
Congestive heart failure	80	8
Chronic obstructive pulmonary disease	68	7
Cerebrovascular disease	36	4
Diagnoses
Sepsis	106	11
Pneumonia	88	9
Acute renal failure	71	7
Cerebrovascular disease	66	7
Acute coronary syndrome	62	6
Urinary tract infection	56	6
Diarrhea	44	4
Encephalopathy	42	4
Gastrointestinal bleeding	36	4

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