Abstract:
Background: Stroke is a leading cause of disability and mortality worldwide, with electrolyte
imbalances are commonly observed in hospitalized patients. Early identification of these
disturbances is critical for improving clinical outcomes. Therefore, this study aimed to assess
serum electrolyte abnormalities and its association with hospital discharge outcomes among
hospitalized acute stroke patients at Jimma University Medical Center.
Methods: A hospital-based cross-sectional study was conducted among 206 acute stroke patients
admitted between April and December 2024. Cox and multi-nominal regression analysis were
performed to identify factors associated with in-hospital mortality and Functional outcome,
respectively.
Results: This study demonstrated distinct patterns in stroke types: ischemic stroke predominated
in older individuals and was associated with cardiac disease, while hemorrhagic stroke was more
common in younger patients and strongly linked to hypertension. Key electrolyte disturbances
included hypercalcemia with hemorrhagic stroke and hyperchloremia with ischemic stroke.
Critically, hyponatremia (AHR=2.6) and hypochloremia (AHR=3.7) independently predicted
higher in-hospital mortality, along with hemorrhagic stroke (AHR=3.9) and lower Glasgow Coma
Scale scores (AHR=0.7). Hypokalemia prolonged hospitalization by 2.7 days. Functional
dependence
correlated
with
hyponatremia,
hypokalemia,
and
hypercalcemia,
though hypocalcemia paradoxically reduced dependence risk (AOR=0.56). The overall in-hospital
mortality rate was 16%.
Conclusion: These findings underscore the prognostic significance of electrolyte monitoring,
particularly sodium, chloride, and potassium imbalances, in acute stroke management.The
unexpected protective role of hypocalcemia merits further exploration. Implementing context
specific protocols in resource-limited settings—emphasizing routine electrolyte assessment, blood
pressure control, and age-stratified care—could mitigate mortality and disability in high-risk
populations.
