Diseases associated with electrolyte imbalance in the ED: age-related differences

Giordano, Mauro; Ciarambino, Tiziana; Castellino, Pietro; Malatino, Lorenzo; Somma, Salvatore Di; Biolo, Gianni; Paolisso, Giuseppe; Adinolfi, Luigi Elio

doi:10.1016/j.ajem.2016.05.056

Cited by 36 publications

(30 citation statements)

References 10 publications

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“…In this study, the incidence of EAD was estimated as 58.0% in cancer patients, which was remarkably higher than reported populations, including patients referred to the emergency department (13.7%) [19] and the elderly (22.0%) [20]. It suggests that EAD in cancer patients should be paid as much attention as other medical conditions, especially in those receiving surgery and chemotherapy.…”

Section: Discussionmentioning

confidence: 62%

Electrolyte and acid-base disorders in cancer patients and its impact on clinical outcomes: evidence from a real-world study in China

et al. 2020

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Background: This study aims to delineate the incidence of electrolyte and acid-base disorders (EAD) in cancer patients, to figure out the risk factors of EAD, then to assess the impact of EAD on patients' in-hospital clinical outcomes. Methods: Patients with the diagnosis of malignancies hospitalized during 1 October 2014 and 30 September 2015 were recruited in Zhongshan Hospital, Fudan University in Shanghai of China. Demographic characteristics, comorbidities, and clinical data, including survival, length of stay and hospital cost, were extracted from the electronic medical record system. Electrolyte and acid-base data were acquired from the hospital laboratory database. Results: Of 25,881 cancer patients with electrolyte data, 15,000 (58.0%) cases had at least one electrolyte and acid-base abnormity. Hypocalcemia (27.8%) was the most common electrolyte disorder, followed by hypophosphatemia (26.7%), hypochloremia (24.5%) and hyponatremia (22.5%). The incidence of simple metabolic acidosis (MAC) and metabolic alkalosis (MAL) was 12.8% and 22.1% respectively. Patients with mixed metabolic acid-base disorders (MAC þ MAL) accounted for 30.2%. Lower BMI score, preexisting hypertension and diabetes, renal dysfunction, receiving surgery/chemotherapy, anemia and hypoalbuminemia were screened out as the major risk factors of EAD. In-hospital mortality in patients with EAD was 2.1% as compared to those with normal electrolytes (0.3%). The risk of death significantly increased among patients with severe EAD. Similarly, the length of stay and hospital cost also tripled as the number and grade of EAD increased. Conclusion: EAD is commonly encountered in cancer patients and associated with an ominous prognosis. Patients with comorbidities, renal/liver dysfunction, and anti-tumor therapy have a higher risk of EAD. Regular monitoring of electrolytes, optimum regimen for intravenous infusion, timely correction of modifiable factors and appropriate management of EAD should not be neglected during anti-tumor treatment.

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Section: Discussionmentioning

confidence: 62%

Electrolyte and acid-base disorders in cancer patients and its impact on clinical outcomes: evidence from a real-world study in China

et al. 2020

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Section: Introductionmentioning

confidence: 99%

“…Electrolyte imbalances (EIs) are common and are associated with increased morbidity and mortality [1,2]. The prevalence of hyponatremia is up to 44.0%, hypocalcemia 25.3%, hypomagnesemia 20.1%, hypophosphatemia 20.0%, hyperkalemia 13.0%, hypernatremia 4.4%, and hypercalcemia 3.0% among hospitalized patients [1,3,4]. EI can be caused by renal insufficiency and age changes in the neurohumoral mechanisms, but can also be caused by different medical conditions like cardiovascular disease, lung diseases and gastrointestinal diseases [1,5].…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of hyponatremia is up to 44.0%, hypocalcemia 25.3%, hypomagnesemia 20.1%, hypophosphatemia 20.0%, hyperkalemia 13.0%, hypernatremia 4.4%, and hypercalcemia 3.0% among hospitalized patients [1,3,4]. EI can be caused by renal insufficiency and age changes in the neurohumoral mechanisms, but can also be caused by different medical conditions like cardiovascular disease, lung diseases and gastrointestinal diseases [1,5]. Many medications like diuretics, beta-blockers, ACEinhibitors, potassium-sparing diuretics, laxatives, antiepileptics, cytostatics also lead to EIs [2,5,6].…”

Section: Introductionmentioning

confidence: 99%

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Electrolyte outpatient clinic at a local hospital – experience from diagnostics, treatment and follow-up

Tazmini

Ranhoff

2020

BMC Health Serv Res

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Background: Electrolyte imbalances (EI) are common among patients. Many patients have repeated hospitalizations with the same EI without being investigated and treated. We established an electrolyte outpatient clinic (EOC) to diagnose and treat patients with EI to improve symptoms and increase their quality of life (QoL). In addition, we also wanted to reduce the number of admissions with the same EI. Methods: Uncontrolled before-after study reporting experiences from this outpatient clinic as a quality assurance project. From October 2010 to October 2015, doctors at our local hospital and general practitioners could refer adult patients with EI to the EOC. Ninety patients with EI were referred, of whom 60 were included. Medical history, clinical examination and laboratory tests were performed, and results registered. Admissions with the same EI were recorded 1 year before and 1 year after consultation at the EOC. Patients responded to a questionnaire, composed by the authors, about symptoms before the first consultation, as well as symptom and QoL improvement after the last consultation. Results: Hyponatremia was the reason for referral in 45/60 patients. The total number of admissions with the same EI 1 year before the first consultation was 71, compared with 20 admissions 1 year after the last consultation. Improvement of symptoms was reported by 60% of patients, and 62% reported improvement in QoL. Conclusions: An EOC may be an appropriate way to organize the assessment and treatment of patients with EI.

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“…Hyponatraemia is the most frequently observed electrolyte abnormality 1. Mild hyponatraemia is associated with cognitive deficits and falls, but in hospitalised patients it is associated with increased mortality 2.…”

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confidence: 99%

Hyponatraemia in primary care

Jacob

Dow

Lasker³

et al. 2019

BMJ

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Diseases associated with electrolyte imbalance in the ED: age-related differences

Cited by 36 publications

References 10 publications

Electrolyte and acid-base disorders in cancer patients and its impact on clinical outcomes: evidence from a real-world study in China

Electrolyte and acid-base disorders in cancer patients and its impact on clinical outcomes: evidence from a real-world study in China

Electrolyte outpatient clinic at a local hospital – experience from diagnostics, treatment and follow-up

Hyponatraemia in primary care

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