Sodium and potassium disorders in patients with COPD exacerbation presenting to the emergency department

Sodium and potassium disorders in patients with COPD exacerbation presenting to the emergency department

COPD, Electrolyte disorders, Emergency, Potassium, Sodium

Background: Electrolyte disorders are common in the emergency department. Hyponatremia is known to be associ‑
ated with adverse outcome in community-acquired pneumonia (CAP) and acute exacerbation of chronic obstructive
pulmonary disease (AECOPD). No studies investigating the prevalence and infuence of hypernatremia or potassium
disorders in patients with AECOPD exist.
Methods: In this retrospective cohort analysis, the prevalence of sodium and potassium disorders was investigated
in patients with AECOPD presenting to an emergency department (ED) between January 1st 2017 and December 31st
2018 and compared to all ED patients with electrolyte measurements and patients presenting with CAP. Exclusion
criteria were age younger than 18 years, written or verbal withdrawal of consent and outpatient treatment. Addition‑
ally, the infuence of dysnatremias and dyskalemias on outcome measured by ICU admission, need for mechanical
ventilation, length of hospital stay, 30-day re-admission, 180-day AECOPD recurrence and in-hospital mortality and
their role as predictors of disease severity measured by Pneumonia Severity Index (PSI) were investigated in patients
with AECOPD.
Results: Nineteen point nine hundred forty-eight ED consultations with measurements of sodium and potassium
were recognized between January 1st 2017 and December 31st 2018 of which 102 patients had AECOPD. Of these
23% had hyponatremia, 5% hypernatremia, 16% hypokalemia and 4% hyperkalemia on admission to the ED. Hypoand hypernatremia were signifcantly more common in patients with AECOPD than in the overall ED population: 23
versus 11% (p=0.001) for hypo- and 5% versus 0.6% (p<0.001) for hypernatremia. In the logistic regression analysis,
no association between the presence of either sodium or potassium disorders and adverse outcome were found.
Conclusion: Dysnatremias and dyskalemias are common in patients with AECOPD with as many as 1 in 5 having
hyponatremia and/or hypokalemia. Hypo- and hypernatremia were signifcantly more common in AECOPD than over‑
all. No signifcant association was found for dysnatremias, dyskalemias and adverse outcomes in AECOPD.

Gregor Lindner, Stefano Herschmann, Georg‑Christian Funk, Aristomenis K. Exadaktylos, Rebecca Gygli and Svenja Ravioli

BMC Emergency Medicine

(2022) 22:49

Fajar Bagus W

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