Association between hyperkalemia at critical care initiation and mortality

Purpose To investigate the association between potassium concentration at the initiation of critical care and all-cause mortality. Methods We performed a retrospective observational study on 39,705 patients, age ≥18 years, who received critical care between 1997 and 2007 in two tertiary care hospita...

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Bibliographic Details
Published in:Intensive care medicine 2012-11, Vol.38 (11), p.1834-1842
Main Authors: McMahon, Gearoid M., Mendu, Mallika L., Gibbons, Fiona K., Christopher, Kenneth B.
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Biological and medical sciences
Boston - epidemiology
Clinical death. Palliative care. Organ gift and preservation
Critical Care
Critical Care Medicine
Critical Illness - mortality
Emergency Medicine
Female
Health aspects
Hospital Mortality
Hospital patients
Hospitalization
Humans
Hyperkalemia
Hyperkalemia - epidemiology
Hyperkalemia - mortality
Intensive
Intensive care
Intensive care medicine
Logistic Models
Male
Massachusetts
Medical research
Medical sciences
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Mortality
Original
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Potassium
Potassium - blood
Regression analysis
Retrospective Studies
Social security
Teaching hospitals
Time Factors
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Summary:Purpose To investigate the association between potassium concentration at the initiation of critical care and all-cause mortality. Methods We performed a retrospective observational study on 39,705 patients, age ≥18 years, who received critical care between 1997 and 2007 in two tertiary care hospitals in Boston, Massachusetts. The exposure of interest was the highest potassium concentration on the day of critical care initiation and categorized a priori as 4.0–4.5, 4.5–5.0, 5.0–5.5, 5.5–6.0, 6.0–6.5, or ≥6.5 mEq/l. Logistic regression examined death by days 30, 90, and 365 post-critical care initiation, and in-hospital mortality. Adjusted odds ratios were estimated by multivariable logistic regression models. Results The potassium concentration was a strong predictor of all-cause mortality 30 days following critical care initiation with a significant risk gradient across potassium groups following multivariable adjustment: K = 4.5–5.0 mEq/l OR 1.25 (95 % CI, 1.16–1.35; P  
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-012-2636-7