(488) Prevalence and Characteristics of Electrolyte Disturbances in Critically Ill Patients With Cancer

Introduction: Electrolyte disturbances are common in critically ill patients and may impact outcomes. Furthermore, various malignancies and cancer treatments are associated with electrolyte disturbances. Despite this, clinical studies evaluating such complications are limited. We aimed to evaluate the prevalence and characteristics of electrolyte disturbances among cancer patients admitted to the intensive care unit (ICU).

Methods: This was a retrospective study that included adult cancer patients admitted to the ICU of a comprehensive cancer center between January and July 2023. We recorded patient characteristics, types of cancer, and reason for ICU admissions. In addition, tests performed in the first 24 hours of admission for the following electrolytes were reviewed: phosphate, magnesium, and potassium. We referred to the institution’s laboratory range to define levels within normal range, elevated, or decreased. Low and high electrolyte levels were further categorized to mild, moderate, and severe, based on the institution’s guidelines. Descriptive statistics were used to report the data.

Results: Over the study period, 645 admissions were recorded for 557 patients. The mean age was 59± 14.2 (SD) years, 319 (57%) patients were males, and 457 (82%) had solid tumors. The most common admission diagnoses were sepsis (n=266, 41%) and respiratory failure (n=128, 20%). Electrolyte imbalances were common among the admissions, with 415 (64%) having at least one electrolyte level outside the normal range. The most common was hypomagnesemia, reported in 341 (53%) admissions, with the majority classified as mild (n=263, 77%) and moderate (n=76, 22%). Hypophosphatemia was reported in 231 (36%) admissions, with 175 (76%) classified as mild, 44 (19%) as moderate, and 12 (5%) as severe. Furthermore, hypokalemia was reported in 110 (17%) admissions, with 76 (69%) classified as mild, 25 (23%) as moderate, and 9 (8%) as severe.

Conclusions: Among a large cohort of critically ill patients with cancer, electrolyte disturbances were reported within the first 24 hours in about two-thirds of the admissions, with the most common being hypomagnesemia and hypophosphatemia. Future studies should identify predictors and potential strategies to minimize such imbalances and complications.