Hypokalemia is frequent and has prognostic implications in stable patients attending the emergency department

Abstract

Background Potassium disturbances are associated with adverse prognosis in patients with chronic conditions. Its prognostic implications in stable patients attending the emergency department (ED) is poorly described. Aims This study aimed to assess the prevalence of dyskalemia, describe its predisposing factors and prognostic associations in a population presenting the ED without unstable medical illness. Methods Post-hoc analysis of a prospective, cross-sectional, multicenter study in the ED of 11 French academic hospitals over a period of 8 weeks. All adults presenting to the ED during this period were included, except instances of self-drug poisoning, inability to complete selfmedication questionnaire, presence of an unstable medical illness and decline to participate in the study. All-cause hospitalization or deaths were assessed. Results A total of 1242 patients were included. The mean age was 57.2±22.3 years, 51% were female. The distribution according to potassium concentrations was: hypokalemia<4mmol/L

Severe hypokalemia in the emergency department: A retrospective, single‐center study

“…It has been reported that 17% of patients with severe hypokalemia died during hospitalization 8 . An increase in short‐term in‐hospital mortality has been reported for patients with hypokalemia 21,22 . It is unclear whether severe hypokalemia itself has an independent impact on patient outcomes; however, potassium is an important determinant of myocardial function, and severe hypokalemia can lead to arrhythmia and sudden cardiac death.…”

“…8 An increase in short-term in-hospital mortality has been reported for patients with hypokalemia. 21,22 It is unclear whether severe hypokalemia itself has an independent impact on patient outcomes; however, potassium is an important determinant of myocardial function, and severe hypokalemia can lead to arrhythmia and sudden cardiac death. The exact cause of death for patients who experienced cardiac arrest was unknown; however, severe hypokalemia may have triggered the sudden death of these patients.…”

Elektrolytstörungen in der Notaufnahme

“…Eine Hypokaliämie ist definiert als eine Kaliumkonzentration von unter 3,5 mmol/l [11,12], wobei ab einer Konzentration von unter 2,5 mmol/l lebensbedrohliche Zustände eintreten können. Ursächlich für eine Hypokaliämie ist entweder eine reduzierte Aufnahme oder sehr viel häufiger eine erhöhte Kaliumausscheidung.…”

Admission plasma potassium and length of hospital stay: a meta-analysis

“…However, significant deficiency (<3 mmol/L) or elevations (>6.5 mmol/L) in plasma potassium may cause life-threatening cardiac arrhythmias and sudden death 1. Unsurprisingly, therefore, within the emergency department both hyperkalaemia and hypokalaemia have been associated with risk for both admission to hospital and mortality 3–6…”

“… 1 Unsurprisingly, therefore, within the emergency department both hyperkalaemia and hypokalaemia have been associated with risk for both admission to hospital and mortality. 3–6 …”