Pattern Of Electrolyte Abnormalities In Emergency Medical Admissions: A Descriptive Observational Study At A Tertiary Care Hospital In Islamabad, Pakistan

Abstract

Electrolyte derangements are amongst the most common and clinically significant abnormalities encountered in emergency medical care with reported prevalence between 24.6% and 84.6% amongst international cohorts of emergency and intensive care patients. Pakistan has rising rates of chronic kidney disease, diabetes mellitus and hypertension, making our populace predisposed to severe and concurrent electrolyte abnormalities. However, there is no study characterizing the combined electrolyte profile - sodium, potassium and chloride together- amongst undifferentiated adult patients presenting to the emergency department of a federal public sector tertiary care hospital in Pakistan. Pakistan Institute of Medical Sciences (PIMS) caters to high acuity patients from Islamabad Capital Territory and neighboring areas who seek emergency medical care. We present baseline data on electrolyte disturbances from our institution. The study aims to outline the pattern and frequency of electrolyte disturbances (sodium, potassium and chloride) among adult patients presenting to emergency department at PIMS Islamabad. To further delineate associated demographic, comorbidity, clinical parameters including renal parameters and laboratory markers of systemic inflammation. This descriptive cross-sectional observational study was carried out at Pakistan Institute of Medical Sciences (PIMS), Islamabad, during February and March of the year 2026. Eight adult patients who satisfied pre-defined eligibility criteria were recruited consecutively from four clinical departments including Emergency Triage, General Medicine, Cardiology (Cardiac Care Centre) and Nephrology. Patients' chart records were reviewed, and pertinent data were extracted using a predesigned seven-domain data collection proforma that included demographics, vital signs, comorbidity, laboratory parameters, clinical management, and outcome. Definition of electrolyte abnormality was based on established international reference ranges. All the analyses were descriptive; IBM SPSS Statistics software version 26.0 was used for entering and analyzing the data. Eight patients were enrolled in this study (six female patients, mean age 48.8 years). The most frequent electrolyte abnormality noted on admission via the emergency department was hyponatraemia, occurring in 75% of patients with severe levels seen in two patients. Hyperkalaemia occurred in 37.5% of patients and hypokalaemia occurred in 25%. End-stage renal disease was confirmed in patients with hyperkalaemia. The most common comorbidity noted was chronic kidney disease, noted in 62.5% of patients. Multiple abnormalities were present in electrolytes or other serum biomarkers in the majority of patients upon admission. It is concluded that serum electrolyte levels should be assessed in patients presenting to emergency departments. If both sodium abnormalities and renal dysfunction are present, patients should be referred to nephrology promptly. The sample size should be increased to 282 patients for a prospective study to obtain results with statistical significance.