PREVALENCE AND PATTERNS OF ELECTROLYTE ABNORMALITIES IN PATIENTS WITH LIVER CIRRHOSIS PRESENTING WITH HEPATIC ENCEPHALOPATHY
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Keywords
Liver cirrhosis, Hepatic encephalopathy, Hyponatremia, Hypokalemia, Electrolyte disturbances, Prognosis
Abstract
To determine the prevalence and types of electrolyte abnormalities in patients with liver cirrhosis presenting with hepatic encephalopathy, and to assess their association with disease severity and short-term outcomes.
Methods: This cross-sectional study was conducted at Women Medical and Dental College, Abbottabad, from January 2023 to January 2024. A total of 71 cirrhotic patients with clinical features of hepatic encephalopathy were enrolled. Demographic details, clinical findings, and laboratory values were recorded. Electrolyte levels, including sodium, potassium, calcium, magnesium, phosphate, and chloride, were measured using standard laboratory protocols. Electrolyte disturbances were categorized as mild, moderate, or severe. Outcomes included grade of encephalopathy, length of hospital stay, ICU admission, and mortality. Data were analyzed using chi-square test, t-test, and logistic regression, with p<0.05 considered significant.
Results: Hyponatremia was the most prevalent abnormality (64.8%), followed by hypokalemia (35.2%) and hypocalcemia (29.6%). Mixed electrolyte disturbances were common, particularly hyponatremia with hypokalemia. Severe electrolyte abnormalities were significantly associated with higher grades of encephalopathy (p=0.01), longer hospital stay (p=0.001), increased ICU admissions (p=0.02), and higher in-hospital mortality (p=0.03).
Conclusion: Electrolyte abnormalities are frequent among cirrhotic patients with hepatic encephalopathy, with hyponatremia as the leading disturbance. Mixed and severe abnormalities are strongly linked with poor outcomes. Routine monitoring and timely correction of electrolyte disturbances should be prioritized to improve prognosis in this patient group.
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Dr Muhammad Hamza
Medical Officer, Department of Internal Medicine, Alnafees Medical College and Hospital, Islamabad, Pakistan
Dr Muhammad Umair Tariq
CESR Fellow in Emergency Medicine at Morriston Hospital Swansea, Wales, United Kingdom
Dr Ommia Kalsoom
Assistant Professor, Department of Physiology, Women Medical College, Abbottabad, Pakistan
Dr Zara Khalid Khan
Associate Professor, Department of Biochemistry, Rawal Institute of Health Sciences, Islamabad, Pakistan
Dr Ahsan Amer
House Officer, Fauji Foundation Hospital, Rawalpindi, Pakistan
Dr Rizwana Kalsoom
Assistant Professor, Department of Biochemistry, Gomal Medical College, Dera Ismail Khan, Pakistan