Acute Hyperkalemia and 30-Day Mortality: Increased Mortality at Slightly Elevated Plasma Potassium Levels

Le résumé fourni par la source

Abstract Background Potassium is involved in multiple physiological processes in the body, and hyper-kalemia is a common, potentially life-threatening condition. Objective The aim of our study was to examine the association between plasma potassium levels, and 30-day mortality in patients presenting to an emergency department with normo- or hyperkalemia. Design Retrospective Cohort study. Setting Emergency Departments in the Capital region of Denmark Participants Persons attending Emergency Departments in the Capital Region of Denmark from 2017-2021 with a plasma potassium level of at least 3.5 mM measured within 4 hours after arrival. Measurements The study was based on data from Danish National Registries and electronic patient records. We performed Kaplan-Meier survival analyses and unadjusted and adjusted cox regression analyses utilizing plasma [K+] 3.5–4.4 mM as the reference group for 30-day mortality hazard ratios (HRs). Results A total of 248,453 patients were included with a median age of 60 years (Q1;Q3 42;75), and 6,959 (2.8%) died within 30 days. Mortality was 2.2% for potassium level 3.5–4.4 mM, 6.9% for 4.5–4.9 mM, 17.1% for 5.0–5.9 mM, and 26.9% for ≥6.0 mM. Unadjusted 30-day HRs were 3.2 (95%CI: 3.0–3.4) for [K+] 4.5–4.9 mM, 8.6 (95%CI: 7.9–9.3) for [K+] 5.0–5.9 mM, and 14.7 (95%CI: 12.5–17.0) for [K+] ≥6.0 mM. Adjusted HRs were 1.4 (1.3–1.5), 2.10 (1.9–2.3), and 2.4 (2.0–2.8), respectively. Limitations Risk of residual confounding. Missing data. No access to data regarding in-hospital treatment. Conclusion Plasma potassium levels above 4.4 mM were associated with increased 30-day mortality among patients presenting to emergency departments. Primary funding source Department of Emergency Medicine, Copenhagen University hospital, Bispebjerg and Frederiksberg Hospital.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.