Analysis of Reported Critical Values and Their Associated Clinical Conditions in a Clinical Chemistry Laboratory of a Tertiary Health Institution in Nigeria

Studies involving critical values in recent time have mainly dwelt on compliance to timely reporting as well as the volumes of the individual reported critical analytes. There is paucity of data however, especially in this environment, on the relationships that exist between reported critical biochemical analytes and the presenting clinical conditions of the patients as at the time of the laboratory investigation. This study therefore sought to investigate such relationships. This study is a retrospective study of data obtained in the year 2018 from the critical value register of the Department of Chemical Pathology, Babcock University Teaching Hospital Ilisan-Remo, Ogun state, Nigeria. Data obtained was analyzed using Statistical Package for Social Sciences (SPSS) version 21.0. Level of statistical significance was set at p < 0.05. Relationship between variables was determined using Chi-square Test. In the year under review, a total of 270 critical values from various biochemical analytes were obtained; out of which 34.0% was potassium, representing the highest occurrence. Calcium had the highest proportion of its tests from the year having critical outcomes (2.2%) compared to other biochemical parameters. Kidney disease was the most frequently reported clinical condition (25.1%) with critical values of biochemical analytes. This study also showed a strong statistical association (p = 0.000) between diabetic ketoacidosis and critical levels of hyperkalemia, critical outcomes of hypocalcaemia and infection/sepsis as well as critical level of azotemia and pregnancy related complications. This study has shown potassium as the most reported critical biochemical analyte which occurred mostly as cases of critical hyperkalemia. This was associated with a high burden of kidney diseases among the study population. The study has also drawn attention to the need for immediate and constant check of blood calcium and urea levels in patients that have sepsis and pregnancy related complications respectively.