Electrolyte Imbalance and Its Prognostic Impact on All-Cause Mortality in ICU Patients with Respiratory Failure

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dc.authorid0000-0002-5397-8841
dc.authorid0000-0003-3599-2719
dc.authorid0000-0003-4634-205X
dc.authorid0000-0002-5090-3262
dc.authorid0000-0002-0968-1549
dc.authorid0000-0002-9449-9302
dc.contributor.authorMentes, Oral
dc.contributor.authorCelik, Deniz
dc.contributor.authorYildiz, Murat
dc.contributor.authorKahraman, Abdullah
dc.contributor.authorCirik, Mustafa Ozgur
dc.contributor.authorDoganay, Guler Eraslan
dc.contributor.authorEnsarioglu, Kerem
dc.date.accessioned2026-01-24T12:26:35Z
dc.date.available2026-01-24T12:26:35Z
dc.date.issued2025
dc.departmentAlanya Alaaddin Keykubat Üniversitesi
dc.description.abstractBackground and Objectives: Chronic obstructive pulmonary disease (COPD) and acute respiratory failure are critical clinical conditions associated with high mortality rates in intensive care units (ICUs). Electrolyte imbalances are significant variables that may influence all-cause ICU mortality in this patient group. In this retrospective study, we aimed to investigate the relationships between the serum levels of sodium (Na+), chloride (Cl-), potassium (K+), calcium (Ca-2(+)), and magnesium (Mg-2(+)) and all-cause ICU mortality in patients admitted with respiratory failure. Additionally, we conducted a detailed mortality analysis on the basis of sodium quartiles and pathological absolute sodium thresholds to reveal their associations with ICU mortality from all causes. Materials and Methods: A total of 1109 patients were analyzed between January 2022 and January 2024. The electrolyte levels measured at ICU admission, demographic data, APACHE II and SOFA scores, arterial blood gas results, BUN and creatinine levels, need for noninvasive mechanical ventilation, length of ICU stay, and survival outcomes were assessed. Statistical analyses were performed via Kaplan-Meier survival analysis and the Cox regression method. Results: Our findings revealed that patients with low potassium and calcium levels had significantly higher mortality rates (p < 0.05). When sodium levels were divided into quartiles, mortality risk markedly increased in both the lowest (Q1) and highest (Q4) quartiles. Cox regression analysis revealed that the mortality risk in hyponatremic patients was 2.2 times greater than that in normonatremic patients (p = 0.005). In the hyponatremic group, the increased mortality risk was statistically borderline significant (p = 0.06). In the logistic regression analysis conducted to evaluate ICU mortality, which included all electrolyte levels and clinical scoring systems, higher APACHE II and SOFA scores were identified as significant risk factors for ICU mortality. Conversely, the presence of COPD was found to be relatively protective compared with other underlying causes of respiratory failure in terms of mortality. Conclusions: Electrolyte imbalances are important predictors of mortality in patients with respiratory failure. Sodium levels exhibit a U-shaped relationship with mortality, with hyponatremia emerging as a prominent risk factor. Careful assessment of electrolyte imbalances is crucial in the clinical management of these patients.
dc.identifier.doi10.3390/medicina61040642
dc.identifier.issn1010-660X
dc.identifier.issn1648-9144
dc.identifier.issue4
dc.identifier.pmid40282932
dc.identifier.scopus2-s2.0-105003588108
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.3390/medicina61040642
dc.identifier.urihttps://hdl.handle.net/20.500.12868/4777
dc.identifier.volume61
dc.identifier.wosWOS:001476481700001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherMdpi
dc.relation.ispartofMedicina-Lithuania
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20260121
dc.subjectrespiratory failure
dc.subjectelectrolyte imbalances
dc.subjecthyponatremia
dc.subjecthypernatremia
dc.subjecthypokalemia
dc.subjecthypocalcemia
dc.subjectICU mortality
dc.titleElectrolyte Imbalance and Its Prognostic Impact on All-Cause Mortality in ICU Patients with Respiratory Failure
dc.typeArticle

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