Clinical outcomes associated with abnormal serum electrolytes in pediatric patients: a single-center study from a tertiary care hospital

Background: Electrolyte abnormalities are common in critically ill children, resulting in morbidity and mortality irrespective of primary problem. Objective: To determine the frequency of normal and deranged/ abnormal serum electrolyte levels among critically ill pediatric patients admitted to the Pediatric Intensive Care Unit (PICU), and to assess the association between electrolyte abnormalities and morbidity and mortality outcomes. Method: This Prospective Cross-sectional Study was conducted in PICU, Department of Paediatrics, Mayo Hospital, Lahore, Pakistan, from August 2024 to January 2025. Written informed consent was obtained from the parents or guardians of the patients. Blood samples were drawn at admission and sent for serum levels of sodium, potassium, and chloride. The frequency of electrolyte abnormalities and their association with outcome variables was determined. Data from all cases were subjected to statistical analysis through SPSS version 26. The Chi-square test was applied in two groups of patients, and Mann–Whitney U test was applied to compare hospital stay. Statistical significance was defined as a p-value ? 0.05. Results: Out of the 93 enrolled children, 54 were male (58.1%), 39 were female (41.9%), and electrolyte imbalance was found in 29 (31.2%). The most common electrolyte abnormality was hyponatremia. Potassium and chloride levels were significantly lower in the imbalance group (p = 0.007 and p = 0.030, respectively), with 95% CIs of –1.1 to –0.2 and –5.0 to –1.5 mmol/L. Sodium showed a trend toward lower values (p = 0.060; 95% CI: –3.5 to –0.5). Patients with electrolyte imbalance had significantly longer PICU stays (6.0 vs 3.0 days; 95% CI: 1.0–5.0; p = 0.017). Mortality was higher in the imbalance group (41.4% vs 25.0%) but was not significant (p = 0.090). Conclusion: Children admitted to the PICU with electrolyte imbalances experience significantly higher mortality rates and longer PICU stay compared to those with normal electrolyte levels.