Study of association of mortality with electrolyte abnormalities in children admitted in pediatric intensive care unit

Abstract

Background: Electrolyte abnormalities are common in critically ill children. In view of importance of electrolyte homeostasis and its significant impact on the final outcome of patient, the present study was undertaken. Objective of this study was to determine the prevalence of electrolyte abnormalities in children admitted in Pediatric Intensive Care Unit at the time of admission and its association with mortality and primary organ system involvement.Methods: The study enrolled all the patients from 29 days to 12 years admitted in PICU of a tertiary care hospital during April 2015 to September 2016 (total 18 months). The children were classified according to presence or absence of electrolyte abnormality. The children were further divided into subgroups based on electrolyte values and mortality and organ system involvement was analyzed in each of the sub groups.Results: The prevalence of electrolyte abnormality in terms of sodium or potassium abnormality in the present study was 44.31% (323 of 729). Hyponatremia (27.43%) was the most common electrolyte abnormality followed by hypokalemia (13.99%). The mortality in children with electrolyte abnormality was found to be 28.8% which was significantly higher than mortality in those without electrolyte abnormality. Maximum children with hyponatremia had central nervous system involvement (48.5%) and those with hypernatremia had gastrointestinal involvement (65.4%). Hypokalemia was most frequently observed with gastrointestinal involvement (54.9%) and hyperkalemia with renal involvement (34.8%).Conclusions: Present study has demonstrated significant association of electrolyte abnormalities at admission in PICU with mortality and primary organ system involvement. Close monitoring and correction of electrolyte abnormalities is essential to reduce morbidity and mortality.