Evidence mapPaperPMID 41649147Full record

ArticleAnnals of medicine2026

Multiple electrolyte imbalances in hospitalized patients: a multimorbidity perspective from a large, retrospective cohort study.

Nan Jiang, Siyu Liang, Yuelun Zhang, Lize Sun, Shi Chen, Hui Pan

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In one paragraph

Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Nan JiangKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.ORCID 0009-0009-0058-3481
Siyu LiangKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.ORCID 0000-0002-3686-2679
Yuelun ZhangPeking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Medical Research Center, Beijing, China.ORCID 0000-0001-7990-9003
Lize SunEight-year Program of Clinical Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Shi ChenKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.ORCID 0000-0003-2205-5371
Hui PanKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.ORCID 0000-0003-2413-0646

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMultiple electrolyte imbalances (MEIs) are underexplored in hospitalized patients. We aimed to determine: (1) the prevalence and prognostic impact of MEIs; (2) the associations between electrolyte imbalance (EI) combinations and adverse outcomes; and (3) the potential interactions among EI types. MATERIALS AND

methodsHospitalized patients at Peking Union Medical College Hospital were enrolled from 2015 to 2020. Adverse outcomes included in-hospital mortality or discharge against medical advice. Multivariable logistic regression models were used to evaluate the associations of number of EIs, EI types, and their combinations with adverse outcomes and to calculate the population-attributable fractions (PAFs). The additive and multiplicative interactions were examined for each EI combination.

resultsAmong 324,056 hospitalizations, the prevalence of MEIs was 18.8%. Compared to patients without EIs, the odds ratios (ORs) for adverse outcomes were 2.18 (95% confidence interval [CI]: 1.83-2.59) for patients with 1 EI and 17.34 (95% CI: 15.32-19.62) for those with ≥2 EIs. The highest-risk EI combinations at the individual level were hypercalcemia-hypernatremia (OR = 14.96 [95% CI: 11.34-19.68]), hyponatremia-hypernatremia (13.00 [95% CI: 10.09-16.74]), and hypochloremia-hypernatremia (11.06 [95% CI: 8.51-14.34]), while hypokalemia-hypernatremia (PAF = 17.89% [95% CI: 17.37%-18.41%]), hyperchloremia-hypernatremia (15.29% [95% CI: 14.99%-15.59%]), and hypocalcemia-hypernatremia (12.40% [95% CI: 11.94%-12.86%]) contributed the most to adverse outcomes at the population level. Synergistic additive interactions were observed for hyperchloremia-hypernatremia (relative excess risk due to interaction = 4.80 [95% CI: 3.05-6.55]) and hypercalcemia-hypernatremia (6.98 [95% CI: 3.11-10.86]).

conclusionsMEIs are common and harmful in hospitalized patients. Prioritizing different intervention targets at individual and population levels may improve clinical outcomes.

Indexed as

Water-Electrolyte ImbalanceAgedFemaleHospitalizationHospital MortalityHumansHypercalcemiaHypernatremiaHypokalemiaHyponatremiaMaleMiddle AgedMultimorbidityPrevalencePrognosisRetrospective StudiesmultimorbidityprevalenceprognosisWater-electrolyte imbalance

Identifiers

PMID41649147
PMCPMC12884999

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.