Evaluation of Electrolyte Imbalances and Their Impact on Mortality in Percutaneous Endoscopic Gastrostomy Patients in the Emergency Department

Authors : Ali Sarıdaş, Naile Fevziye Mısırlıoglu, Nedim Uzun, Türker Acehan, Sumeyye Nur Aydin, Aysun Ekinci, Hafize Uzun
Pages : 659-670
Doi:10.5798/dicletip.1840507
View : 92 | Download : 143
Publication Date : 2025-12-12
Article Type : Research Paper
Abstract :Introduction: Percutaneous endoscopic gastrostomy (PEG) is a nutritional intervention used in patients with impaired oral intake but a functioning gastrointestinal system. PEG is considered the gold standard access route for long-term enteral nutrition. This study aims to evaluate the changes in serum electrolyte levels in patients with PEG presenting to the Emergency Department (ED) and to investigate their association with clinical outcomes, including morbidity and mortality. Methods: In this single-center retrospective cohort study, 87 patients with PEG admitted to the ED between January 1, 2021, and January 1, 2025, were analyzed. Results: The mean age was 70.2 ± 6.8 years, and 36.8% were female. The most common admission reason was tube obstruction/leakage (48.3%). Electrolyte disturbances were detected in 21.8% of patients. The overall mortality rate was 9.2%, with all deceased patients exhibiting electrolyte abnormalities(p<0.001). Hypochloremia, hypophosphatemia, and elevated bicarbonate levels were significantly associated with mortality (p<0.001 for all). Normal calcium and potassium levels correlated with increased survival (p<0.001; p=0.001, respectively). Elevated inflammatory markers (LDH, WBC, CRP) were significantly higher in non-survivors (p<0.05). Logistic regression identified increased bicarbonate level as an independent risk factor for mortality (OR 1.36; 95% CI 1.08–1.72; p=0.01). No significant associations were found between electrolyte levels and morbidity, except higher magnesium and inflammatory markers in patients with neurological or infectious complications. Conclusion: Electrolyte disturbances, particularly hypochloremia, hypophosphatemia, and elevated bicarbonate, are strongly associated with mortality in PEG patients presenting to the ED. Close monitoring and correction of electrolytes may improve outcomes in this vulnerable population
Keywords : Bikarbonat, Elektrolit Bozukluğu, Acil Servis, Mortalite, Perkütan Endoskopik Gastrostomi (PEG).

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