Hypokalaemia in hospitalised patients

Greco, A; Rabito, Giovanni; Pironi, Michela; Bissig, Marco; Parlato, Saida; Andreocchi, L.; Bianchi, G.; M, Poretti Guigli; Llamas, Michael; Monotti, Rita; Sciolli, L; Ravetta, F.; R, Della Bruna; Zasa, Anna; Stehrenberger, D; Giannini, Olivier; Gabutti, Luca

doi:10.4414/smw.2016.14320

Cited by 12 publications

(25 citation statements)

References 15 publications

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“…The prevalence of rate of hypokalemia in our study group of 70.37% was higher than the rate previously reported for a general group of hospitalized patients [ 5 ]. Hypokalemia is common in hospitalized patients.…”

Section: Discussioncontrasting

confidence: 80%

“…Although hypokalemia is often asymptomatic, it remains a risk factor of gastrointestinal disorders and serious perioperative and postoperative arrhythmia [ 16 – 19 ]. Hypokalemia might also contribute to delayed recovery from anesthesia [ 20 ], as well as increasing the length of hospital stay and the risk for all-cause and cardiovascular-related mortality [ 5 , 21 ]. Among our study group, the time to first feces was significantly longer among patient with than without hypokalemia.…”

Section: Discussionmentioning

confidence: 99%

“…Perioperative (including before,during and after surgery) serum potassium levels are closely associated with postoperative clinical outcomes after gastrointestinal surgery [ 1 ], including the recovery of gastrointestinal function, the risk for acute kidney injury and adverse cardiovascular events, as well as in-hospital mortality [ 2 – 4 ]. Hypokalemia occurs frequently, being identified in over one fifth of hospitalized patients [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and risk factors for hypokalemia in patients scheduled for laparoscopic colorectal resection and its association with post-operative recovery

Zhu

Tan

et al. 2018

BMC Gastroenterol

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BackgroundPerioperative serum potassium levels are closely associated with postoperative clinical outcomes after gastrointestinal surgery. The aim of our retrospective study was to identify the prevalence and risk factors for preoperative hypokalemia (before pneumoperitoneum) and to evaluate the influence of preoperative hypokalemia on the recovery of postoperative gastrointestinal function.MethodsIn this retrospective study, patients scheduled for laparoscopic colorectal resection from November 11 2014 to October 20 2016, were considered for inclusion. A blood potassium level between 3.5 and 5.5 mmol/L was defined as normal, with levels between 3.0 to 3.5 mmol/L, 2.5 to 3.0 mmol/L and < 2.5 mmol/L considered as slight, moderate, and severe level of hypokalemia. The factors including age, gender, ASA grade, BMI, hypertension, diabetes, anti-hypertension drugs, lactose oral soluble, oral cathartics, oral cathartics, cathartic enemas, and blood potassium level before gastrointestinal preparation which might be associated with blood potassium level before pneumoperitoneum were analysed. The time to postoperative first flatus (FFL) and first feces (FFE) was compared between patients with and without hypokalemia.ResultsThe final analysis was based on the data of 108 patients. Hypokalemia was identified in 70.37% patients, with the following distribution of blood potassium levels before pneumoperitoneum: slight, 49 (45.37%) patients; moderate, 23 (21.30%); and severe, 4 (3.70%) patients. Hypokalemia was significantly associated with hypertension and the use of ≥2 types of oral cathartics for preoperative gastrointestinal preparation. With treatment, potassium levels recovered to normal levels in all patients within 48 h postoperatively. Hypokalemia was associated with a longer postoperative time to first feces, compared to patients with a normal potassium level before pneumoperitoneum.ConclusionsOur findings underlie the importance of early monitoring and management of serum potassium levels in these patients.

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Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence and risk factors for hypokalemia in patients scheduled for laparoscopic colorectal resection and its association with post-operative recovery

Zhu

Tan

et al. 2018

BMC Gastroenterol

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“…Hypokalemia is common in hospitalized patients; approximately 20% of inpatients experience hypokalemia [16]. Perioperative hypokalemia is even higher in patients scheduled for laparoscopic colorectal resection.…”

Section: Discussionmentioning

confidence: 99%

Effects of Preoperative Oral Carbohydrate Electrolyte Drinks on Preoperative Hypokalemia Incidence in Patients Scheduled for Laparoscopic Colorectal Resection: A Randomized Clinical Trial

Tan¹,

Deng²,

Hu³

et al. 2020

Preprint

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Background: In our previous study, hypokalemia incidence was high in patients scheduled for laparoscopic colorectal resection. The present trial was conducted to verify the effects of preoperative carbohydrate drinks containing potassium in these patients.Methods: Patients were randomly assigned to control, placebo, and case groups. In control group, patients were fasted from midnight. In placebo group, patients were fasted from midnight and received carbohydrate drinks 2–3 h before surgery. In case group, patients were fasted from midnight and received carbohydrate drinks containing potassium supplementation 2–3 h before surgery. The primary outcome was the incidence and severity of preoperative hypokalemia. The other outcomes included postoperative gastrointestinal function, including the time to postoperative first flatus (FFL) and first feces (FFE) and other complications. Results: The final analysis included 122 participants. The incidence of preoperative hypokalemia in case group was significantly lower than that in control and placebo groups (50% vs. 88.1% vs. 77.5%, p < 0.001). The severity of hypokalemia in control and placebo groups was greater than that in case group. No regurgitation or aspiration occurred in the three groups. No significant differences were observed among the three groups regarding time to FFL and FFE. Conclusions: Preoperative carbohydrate drinks containing potassium may have significantly reduced the incidence of preoperative hypokalemia and improved preoperative thirst and hunger, but did not improve postoperative well-being. However, as part of the enhanced recovery after surgery protocol, preoperative carbohydrate drinks containing potassium should be recommended, as early as first admittance to hospital. Trial registration: The study was registered with the Chinese Clinical Trial Registry at www.chictr.org on February 7, 2017 (registration number: ChiCTR-IOR-17010561).

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“…Previous studies have shown that hypokalemia is a common clinical postoperative complication. General surgery, neurosurgery, obstetrics and gynecology and other departments have reported that the hypokalemia rate is 25%, and will cause many adverse symptoms of patients [15]. There are only a few reports on the level of potassium after orthopedic surgery, about 25% resulting in hypokalemia in joint surgery, and also can bring some low potassium symptoms.…”

Section: Introductionmentioning

confidence: 99%

The Incidence And Risk Factors of Serum Hypokalemia After Primary Total Joint Arthroplasty

Pan

Zhang

et al. 2021

Preprint

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Background: Regular monitoring of serum potassium after total joint arthroplasty (TJA) is a routine examination, which can detect abnormal serum potassium and reduce adverse events timely caused by postoperative hypokalemia. In this study, we aimed to investigate the incidence and risk factors of hypokalemia after primary total hip and knee replacement.Methods: This study included patients who underwent unilateral total knee or hip arthroplasty in our department from April 2017 to March 2018. The serum potassium level before and after operation was collected and retrospectively analyzed. The differences in age, BMI and other factors between hypokalemia patients and non-hypokalemia patients at different time points after surgery were compared, and then the risk factors of postoperative hypokalemia were analyzed based on multiple logistic regression.Results: The total incidence of postoperative hypokalemia was 53.1%, while the respective rate on the first, third and fifth postoperative day was 12.5%, 40.7% and 9.6%. The serum potassium level on the first, third and fifth postoperative day was 3.84±0.32mmol/l, 3.59±0.34mmol/l and 3.80±0.32mmol/l, while among which, the level on the third day was the lowest (p=0.015). The independent risk factors for hypokalemia after total hip and knee replacement were the level of preoperative serum potassium (p=0.011), preoperative red blood cells (p=0.027), and a history of diabetes (p=0.007).Conclusion: Regular monitoring of serum potassium should be performed after TJA due to hypokalemia was a very common complication. We need to pay more attention to patients’ preoperative potassium and red blood cells, especially patients with diabetes.

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Hypokalaemia in hospitalised patients

Cited by 12 publications

References 15 publications

Prevalence and risk factors for hypokalemia in patients scheduled for laparoscopic colorectal resection and its association with post-operative recovery

Prevalence and risk factors for hypokalemia in patients scheduled for laparoscopic colorectal resection and its association with post-operative recovery

Effects of Preoperative Oral Carbohydrate Electrolyte Drinks on Preoperative Hypokalemia Incidence in Patients Scheduled for Laparoscopic Colorectal Resection: A Randomized Clinical Trial

The Incidence And Risk Factors of Serum Hypokalemia After Primary Total Joint Arthroplasty

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