Prevalence, Risk Factors and Clinical Outcomes of Dysnatremia in Patients Admitted to Medical Intensive Care Unit: A Prospective Observational Study

Abstract

Dysnatremia, encompassing both hyponatremia and hypernatremia, is a frequent electrolyte abnormality among critically ill patients and is associated with adverse clinical outcomes. This prospective observational study was conducted to determine the prevalence of dysnatremia, identify associated risk factors, and evaluate its impact on clinical outcomes among patients admitted to the Medical Intensive Care Unit (MICU). A total of 100 adult patients with normal serum sodium levels at admission were enrolled and followed during their MICU stay. Serum sodium levels were monitored daily, and patients were categorized into eunatremic, hyponatremic, or hypernatremic groups. Demographic characteristics, comorbidities, hemodynamic status, need for mechanical ventilation, vasopressor use, and length of ICU stay were recorded. Dysnatremia developed in a substantial proportion of patients during ICU stay, with hyponatremia being more common than hypernatremia. Patients with dysnatremia had significantly longer ICU stay and higher rates of mechanical ventilation and mortality compared to eunatremic patients. Major contributing factors included sepsis, renal dysfunction, inappropriate fluid therapy, diuretic use, and hormonal disturbances. The study highlights the importance of early detection and careful management of sodium imbalance in MICU patients to improve outcomes and reduce ICU-related morbidity and mortality.