Prevalence and characteristics of electrolyte disturbances among inpatients and outpatients: A cross-sectional study

 

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https://storage.unitedwebnetwork.com/files/1099/79d9a6a14493571dd7f93db1302f84de.pdf
Prevalence and characteristics of electrolyte disturbances among inpatients and outpatients: A cross-sectional study

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Nobutaka
Okada
Nobutaka Okada n.okada@med.kindai.ac.jp Kindai University Faculty of Medicine Division of Nephrology, Department of Internal Medicine Osaka Japan *
Miho Murashima murashimam@med.kindai.ac.jp Kindai University Faculty of Medicine Division of Nephrology, Department of Internal Medicine Osaka Japan -
Shohei Manabe manabeshohei@med.kindai.ac.jp Kindai University Faculty of Medicine Division of Nephrology, Department of Internal Medicine Osaka Japan -
Norihiro Kobayashi n-korin@med.kindai.ac.jp Kindai University Faculty of Medicine Division of Nephrology, Department of Internal Medicine Osaka Japan -
Yoshihisa Nakatani y-nakata@med.kindai.ac.jp Kindai University Faculty of Medicine Division of Nephrology, Department of Internal Medicine Osaka Japan -
Shuji Arima shuarima@med.kindai.ac.jp Kindai University Faculty of Medicine Division of Nephrology, Department of Internal Medicine Osaka Japan -
 
 
 
 
 
 
 
 
 

Clarifying the characteristics of electrolyte disturbances, including seasonal variations, in both inpatients and outpatients, may help in developing preventive and therapeutic strategies. This study aimed to investigate the prevalence and clinical features of electrolyte disturbances in hospital and community settings.

We conducted a cross-sectional study at Kindai University Hospital. Adults aged ≥18 years who underwent serum electrolyte measurements (sodium, potassium, calcium, phosphate, and magnesium) on five representative weekdays in each season of 2024 were included. Electrolyte disturbances were defined according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Hypophosphatemia (<2.0 mg/dL) and hyperphosphatemia (>6.0 mg/dL) were defined clinically, as they are not defined in CTCAE. Prevalence rates and clinical characteristics of electrolyte disturbances were compared between inpatients and outpatients using descriptive statistics.

A total of 19,489 electrolyte measurements from 15,457 patients were included. The mean age was 66.9 years, 50.5% were men, and the mean estimated glomerular filtration rate was 66.4 mL/min/1.73m². Electrolyte disturbances were more common among inpatients than outpatients. The inpatient-to-outpatient ratio was highest for hypernatremia (19.5), while lower ratios (2.3-4.4) were observed for hypomagnesemia, hypocalcemia, hyperkalemia, and hyperphosphatemia.

The prevalence of hyponatremia among outpatients were higher in summer (0.52 events per patient) than in other seasons (0.23-0.39 events per patient), although the difference was not statistically significant. Otherwise, no seasonal variation was observed. Phosphate and magnesium measurements were less common (approximately one-fifth and one-tenth, respectively, compared to sodium and potassium). Magnesium measurements were most frequently requested by oncologists and hematologists for both inpatients and outpatients. In contrast, phosphate measurements were most ordered by nephrologists for outpatients and by gastroenterologists for inpatients. The prevalence rate of hyponatremia was highest among outpatients treated at emergency department and among inpatients treated by pulmonologists. Hyperkalemia was most prevalent among patients managed by emergency physicians, followed by the nephrologists, in the outpatient setting. It was also most prevalent in inpatients treated at intensive care units, followed by those treated by nephrologists.

Electrolyte disturbances were more frequent in inpatients than in outpatients. Inpatient to outpatient rates, and distribution by subspecialities vary depending on electrolyte disturbances, which suggest different etiologies. 

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