Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Department of Pediatric Nephrology, Lin-Kou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Pediatr Neonatol. 2022 Nov;63(6):575-581. doi: 10.1016/j.pedneo.2022.04.008. Epub 2022 Jul 19.
This study evaluated the prevalence and frequency of serum electrolyte abnormalities (SEAs) in children presenting to a pediatric emergency department (PED) with various diseases.
Pediatric patients (≤18 years) with blood electrolyte panels obtained in the PED of Lin-Kou Chang Gung Memorial Hospital, Taiwan, in the 5 years from January 1, 2016, to August 31, 2021, were enrolled in this retrospective observational study. Patients were divided into three age groups: Group A, < 4 years; Group B, 4-11 years; and Group C, 12-18 years. The associations between SEAs and clinical diseases in children and age-related differences were assessed.
This study included 182,058 pediatric patients visiting our PED over a 5-year period. A total of 250 (0.14%) patients with SEAs were included in the analysis. The study population consisted of 127 boys and 123 girls with a median (IQR) age of 9.0 (3.2-14.1) years. Hospital admission was required in 86.4% (n = 216) of the patients, and 32.4% (n = 81) of them were admitted to the pediatric intensive care unit (PICU). The median (IQR) hospital stay and PICU stay was 6.5 (4.0-11.0) and 4.0 (3.0-8.0) days, respectively. The PICU stay was longer in Group A (p < 0.05) and shorter in group C (p < 0.05). Hyponatremia was the most common SEA in group A (46.3%, n = 31), while hypokalemia was common in groups B (54.2%, n = 52) and C (32.2%, n = 28). Gastrointestinal, renal, and endocrine diseases were common clinical conditions associated with SEAs in pediatric patients in our PED.
The detection rate of SEAs in patients in the PED was 0.14%. Hyponatremia was a common SEA in pediatric patients aged <4 years, while the most common electrolyte disorder in those >4 years old was hypokalemia. In infants and young children, SEAs were associated with a longer PICU stay.
本研究评估了在儿科急诊就诊的患有各种疾病的儿童中血清电解质异常（SEAs）的发生率和频率。
本回顾性观察研究纳入了 2016 年 1 月 1 日至 2021 年 8 月 31 日期间在台湾林口长庚纪念医院儿科急诊进行血液电解质检测的儿科患者（≤18 岁）。患者分为三组：A 组，<4 岁；B 组，4-11 岁；C 组，12-18 岁。评估了 SEAs 与儿童临床疾病之间的关系，并分析了与年龄相关的差异。
本研究纳入了 5 年内我院儿科急诊就诊的 182058 名患儿。共纳入 250 例（0.14%）SEAs 患儿进行分析。研究人群中男 127 例，女 123 例，中位（IQR）年龄为 9.0（3.2-14.1）岁。86.4%（n=216）的患儿需要住院治疗，其中 32.4%（n=81）患儿入住儿科重症监护病房（PICU）。患儿中位（IQR）住院时间和 PICU 住院时间分别为 6.5（4.0-11.0）天和 4.0（3.0-8.0）天。A 组患儿 PICU 住院时间较长（p<0.05），C 组患儿较短（p<0.05）。A 组最常见的 SEA 是低钠血症（46.3%，n=31），B 组和 C 组最常见的 SEA 是低钾血症（B 组 54.2%，n=52；C 组 32.2%，n=28）。胃肠道、肾脏和内分泌疾病是儿科患者在我院儿科急诊就诊时出现 SEAs 的常见临床情况。
在儿科急诊就诊的患者中，SEAs 的检出率为 0.14%。<4 岁患儿中常见的 SEA 是低钠血症，>4 岁患儿中最常见的电解质紊乱是低钾血症。在婴儿和幼儿中，SEAs 与 PICU 住院时间延长有关。
