Atiklet Zerihun Zewdie^1,, Addisu Melkie Ejigu¹, Henok Bahru Wodajeneh¹, Muluken Alemayehu Workiye², Ayanaw Guadie Mamo³, Eyosias Lemma Teshome⁴, Mahlet Seyoum Shiferaw⁵

Background: Electrolyte disturbance is common in critically ill patients and it is independently associated with increased short-term and long-term morbidity and mortality. The main objective of this study was to assess the prevalence, associated factors and outcome of dysnatrmia and dyskalemia in the ICUs of BLH, St peter's and Yekatit 12 hospitals. Methods: This was a prospective, hospital-based cohort study of critically ill patients admitted to the ICUs of BLH, St peter's and Yekatit12 hospital between May 1, 2021 and August 31, 2021. A structured questionnaire was used to collect information on sociodemographic characteristics, clinical profile at admission, and outcomes at discharge.To identify determinants of dysnatremia and dyskalemia, bivariable and multivariable binary logistic regression analyses were done. Statistical significance was considered at the level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association. Result: A total of 159 patients included in the study. The majority (64.2%) of study participants are from St. Peter. More than one-third (38.4%) of them were in the age group of 31-50 years. The frequency of hyponatremia was 49.68% while Hypernatremia has been found in 25.48% of ICU admitted patients. The magnitude of hypo and hyperkalemia is found out to be 39.49% and 24.2% respectively. A total of 70.06% of patients were dysnatremic while 61.15% were dyskalemic.The odds of hyponatremia increase 4.53 times with admission diagnosis of endocrine than non-endocrine admissions [AOR=4.53; 95% CI: 1.64 - 12.53], Similarly the odds of hyponatremia increased 3.95 times with those taking beta blockers [AOR= 3.95; 95% CI: 1.43 - 10.97].hypernatremia increased 3.17 times in those who took sedatives as compared to those who didn’t [AOR=3.17; 95% CI: 1.28- 7.86] and in those with diagnosis of AKI in their hospital stay.a single unit increase on the mean chloride increased the odds of hypernatremia by1.16 times [AOR=1.16; 95% CI: 1.08- 1.24].Those with admission diagnosis of COVID 19 were 75% less risk of developing hypokalemia than those with non-covid admissions [AOR=0.25; 95% CI: 0.11- 0.61].Those with use of beta blockers were 95% less risk of developing hyperkalemia as compared to those who don’t use betablockers [AOR=0.05; 95% CI: 0.01-0.48]. one unit increase in the mean urea increases the risk of hyperkalemia by 1.02 times [AOR=1.02; 95% CI: 1.01- 1.03]. Hypernatremia increased the risk of death 2.73 times among patients in the ICU than those with no hypernatremia. [AOR=2.73; 95% CI: 1.28- 5.85]. similarly, those patients in the ICU with hyperkalemia were 2.43 times more at risk to die than those with no hyperkalemia. [AOR=2.43; 95% CI: 1.13- 5.25]. Conclusion: This study demonstrated that dysnatrmia and dyskalemia are frequent findings in the critically ill. There are different determinant factors for the development of dysnatremia and dyskalemia in the ICU. Critically ill patients with hypernatremia and hyperkalemia had a higher incidence of thirty-day ICU mortality.

dysnatremia, dyskalemia, thirty-day ICU mortality