Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun;15(3):239-43.
doi: 10.7861/clinmedicine.15-3-239.

Serum potassium levels as an outcome determinant in acute medical admissions

Richard Conway  1 , Donnacha Creagh  2 , Declan G Byrne  1 , Deirdre O'Riordan  3 , Bernard Silke  4
Affiliations

Serum potassium levels as an outcome determinant in acute medical admissions

Richard Conway et al. Clin Med (Lond). 2015 Jun.

Abstract

The relationship between serum potassium levels and mortality in acute medical admissions is uncertain. In particular, the relevance of minor abnormalities in potassium level or variations within the normal range remains to be determined. We performed a retrospective cohort study of all emergency medical admissions to St James's Hospital (Dublin, Ireland) between 2002 and 2012. We used a stepwise logistic regression model to predict in-hospital mortality, adjusting risk estimates for major predictor variables. There were 67,585 admissions in 37,828 patients over 11 years. After removing long-stay patients, 60,864 admissions in 35,168 patients were included in the study. Hypokalaemia was present in 14.5% and hyperkalaemia in 4.9%. In-hospital mortality was 3.9, 5.0, and 18.1% in the normokalaemic, hypokalaemic and hyperkalaemic groups respectively. Hypokalaemic patients had a univariate odds ratio (OR) of 1.29 for in-hospital mortality (95% confidence interval (CI) 1.16-1.43; p<0.001). Hyperkalaemic patients had a univariate OR for in-hospital mortality of 5.2 (95% CI 4.7-5.7; p<0.001). The ORs for an in-hospital death for potassium between 4.3 and 4.7 mmol/l, and 4.7 and 5.2 mmol/l, were 1.73 (95% CI 1.51-1.99) and 2.97 (95% CI 2.53-3.50) respectively. Hyperkalaemia and hypokalaemia are associated with increased mortality.

Keywords: Mortality; emergency admissions; outcomes; potassium.

PubMed Disclaimer

Figures

Fig 1.
Fig 1.
Quadratic plot (with 95% CI) demonstrating the relationship between presenting potassium and 30-day in-hospital mortality. CI = confidence interval.
Fig 2.
Fig 2.
Admission potassium and 30-day in-hospital mortality. CI = confidence interval.
See this image and copyright information in PMC

References

    1. Nyirenda MJ, Tang JI, Padfield PL, Seckl JR. Hyperkalaemia. BMJ 2009;339:b4114. - PubMed
    1. Gennari FJ. Hypokalaemia. N Engl J Med 1998;339:451–8. - PubMed
    1. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction). Circulation 2004;110:e82–e292. - PubMed
    1. Cohn JN, Kowey PR, Whelton PK, Prisant LM. New guidelines for potassium replacement in clinical practice: a contemporary review by the National Council on Potassium in Clinical Practice. Arch Intern Med 2000;160:2429–36. - PubMed
    1. Macdonald JE, Struthers AD. What is the optimal serum potassium level in cardiovascular patients? J Am Coll Cardiol 2004;43:155–61. - PubMed