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Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study
BACKGROUND: Although electrolyte imbalances (EIs) are common in the emergency department (ED), few studies have examined the occurrence of such conditions in an unselected population. OBJECTIVES: To investigate the frequency of EI among adult patients who present to the ED, with regards to type and...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483356/ https://www.ncbi.nlm.nih.gov/pubmed/31022222 http://dx.doi.org/10.1371/journal.pone.0215673 |
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author | Tazmini, Kiarash Nymo, Ståle H. Louch, William E. Ranhoff, Anette H. Øie, Erik |
author_facet | Tazmini, Kiarash Nymo, Ståle H. Louch, William E. Ranhoff, Anette H. Øie, Erik |
author_sort | Tazmini, Kiarash |
collection | PubMed |
description | BACKGROUND: Although electrolyte imbalances (EIs) are common in the emergency department (ED), few studies have examined the occurrence of such conditions in an unselected population. OBJECTIVES: To investigate the frequency of EI among adult patients who present to the ED, with regards to type and severity, and the association with age and sex of the patient, hospital length of stay (LOS), readmission, and mortality. METHODS: A retrospective cohort study. All patients ≥18 years referred for any reason to the ED between January 1, 2010, and December 31, 2015, who had measured blood electrolytes were included. In total, 62 991 visits involving 31 966 patients were registered. RESULTS: EIs were mostly mild, and the most common EI was hyponatremia (glucose-corrected) (24.6%). Patients with increasing severity of EI had longer LOS compared with patients with normal electrolyte measurements. Among all admitted patients, there were 12928 (20.5%) readmissions within 30 days from discharge during the study period. Hyponatremia (glucose-corrected) was associated with readmission, with an adjusted odds ratio (OR) of 1.25 (95% CI, 1.18–1.32). Hypomagnesemia and hypocalcemia (albumin-corrected) were also associated with readmission, with ORs of 1.25 (95% CI, 1.07–1.45) and 1.22 (95% CI, 1.02–1.46), respectively. Dysnatremia, dyskalemia, hypercalcemia, hypermagnesemia, and hyperphosphatemia were associated with increased in-hospital mortality, whereas all EIs except hypophosphatemia were associated with increased 30-day and 1-year mortality. CONCLUSIONS: EIs were common and increasing severity of EIs was associated with longer LOS and increased in-hospital, 30-days and 1-year mortality. EI monitoring is crucial for newly admitted patients, and up-to-date training in EI diagnosis and treatment is essential for ED physicians. |
format | Online Article Text |
id | pubmed-6483356 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-64833562019-05-09 Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study Tazmini, Kiarash Nymo, Ståle H. Louch, William E. Ranhoff, Anette H. Øie, Erik PLoS One Research Article BACKGROUND: Although electrolyte imbalances (EIs) are common in the emergency department (ED), few studies have examined the occurrence of such conditions in an unselected population. OBJECTIVES: To investigate the frequency of EI among adult patients who present to the ED, with regards to type and severity, and the association with age and sex of the patient, hospital length of stay (LOS), readmission, and mortality. METHODS: A retrospective cohort study. All patients ≥18 years referred for any reason to the ED between January 1, 2010, and December 31, 2015, who had measured blood electrolytes were included. In total, 62 991 visits involving 31 966 patients were registered. RESULTS: EIs were mostly mild, and the most common EI was hyponatremia (glucose-corrected) (24.6%). Patients with increasing severity of EI had longer LOS compared with patients with normal electrolyte measurements. Among all admitted patients, there were 12928 (20.5%) readmissions within 30 days from discharge during the study period. Hyponatremia (glucose-corrected) was associated with readmission, with an adjusted odds ratio (OR) of 1.25 (95% CI, 1.18–1.32). Hypomagnesemia and hypocalcemia (albumin-corrected) were also associated with readmission, with ORs of 1.25 (95% CI, 1.07–1.45) and 1.22 (95% CI, 1.02–1.46), respectively. Dysnatremia, dyskalemia, hypercalcemia, hypermagnesemia, and hyperphosphatemia were associated with increased in-hospital mortality, whereas all EIs except hypophosphatemia were associated with increased 30-day and 1-year mortality. CONCLUSIONS: EIs were common and increasing severity of EIs was associated with longer LOS and increased in-hospital, 30-days and 1-year mortality. EI monitoring is crucial for newly admitted patients, and up-to-date training in EI diagnosis and treatment is essential for ED physicians. Public Library of Science 2019-04-25 /pmc/articles/PMC6483356/ /pubmed/31022222 http://dx.doi.org/10.1371/journal.pone.0215673 Text en © 2019 Tazmini et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Tazmini, Kiarash Nymo, Ståle H. Louch, William E. Ranhoff, Anette H. Øie, Erik Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study |
title | Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study |
title_full | Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study |
title_fullStr | Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study |
title_full_unstemmed | Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study |
title_short | Electrolyte imbalances in an unselected population in an emergency department: A retrospective cohort study |
title_sort | electrolyte imbalances in an unselected population in an emergency department: a retrospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483356/ https://www.ncbi.nlm.nih.gov/pubmed/31022222 http://dx.doi.org/10.1371/journal.pone.0215673 |
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