THE ROLE OF ELECTROLYTE IMBALANCE IN ASSESSING DISEASE SEVERITY AND OUTCOMES IN ACUTE EXACERBATION OF COPD: A TERTIARY CARE HOSPITAL STUDY.

J Peop Univ Med Health Sci. 2025:15(3), 80-86. http://doi.org/10.46536/jpumhs/2025/15.03.661

Abstract

BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD)
significantly increase morbidity and mortality. Electrolyte imbalances are common in hospitalized patients
with AECOPD, but their prevalence, clinical correlations, and impact on outcomes in South Asian tertiary
care settings remain underexplored. Determining the prevalence of electrolyte anomalies, such as those
involving sodium, potassium, chloride, calcium, and magnesium, in AECOPD and evaluating their
correlation with the severity of the disease and in-hospital outcomes are the goals of this study.
OBJECTIVE: The study's goal is to find out how common and what kinds of electrolyte imbalances
patients with AECOPD have in a Karachi tertiary care hospital, as well as how they relate to the disease's
severity and in-hospital outcomes. DESIGN: Since this research is a prospective observational study, data
will be gathered starting at the time of patient admission and continuing throughout time. Without
changing the management or treatment plan, the research will record clinical data in real time. An in
depth study of how electrolyte imbalances arise and connect to the course and results of disease will be
possible by tracking patients during their hospital stay. RESEARCH LOCATION: The study was
conducted in Karachi, Pakistan, at the Jinnah Postgraduate Medical Centre (Ward 12, Chest Medicine
Centre). RESEARCH DURATION: The research was conducted from early February 2025 to the end
of July 2025. METHODS: A prospective observational research was carried at the Department of Chest
Medicine (Ward 12), Jinnah Postgraduate Medical Centre, Karachi, from February 2025 to July 2025.
Consecutive patients ≥40 years with spirometry-confirmed COPD admitted with AECOPD were enrolled.
Serum sodium, potassium, calcium, magnesium, and chloride were measured within 24 hours of
admission. Electrolyte disturbances were defined using standard laboratory reference ranges. Outcomes
included disease severity (GOLD criteria), ICU admission, need for mechanical ventilation, hospital stay,
and in-hospital mortality. Logistic regression was used to recognize predictors of severe AECOPD.
RESULTS: The study included 150 patients with a mean age of 63.8 ± 9.7 years, 74.7% of whom were
male. 82.7% of patients had electrolyte abnormalities, with the most prevalent being hyponatraemia
(57.3%), hypokalaemia (42.7%), hypochloremia (27.3%), hypocalcaemia (25.3%), and hypomagnesaemia
(19.3%). CONCLUSION: Electrolyte imbalances—particularly hyponatremia, hypokalemia, and
hypochloremia—are highly prevalent in AECOPD and are strongly linked to increased disease severity,
prolonged hospitalization, and mortality. Routine electrolyte monitoring, including chloride, and prompt
correction should be integral to the management of hospitalized AECOPD patients to improve outcomes.