Serum electrolyte abnormalities and its association with Hospital discharge outcome among hospitalized acute stroke Patients: institution based cross sectional study at jimma Medical center, southwest, Ethiopia

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.