Abnormal potassium level predicts short-term readmissions in patients with acute dyspnea
| Author | Affiliation |
|---|---|
Žeimaitė, Rasa | |
| Date |
|---|
2017-04-29 |
eISSN: 1879-0844.
Funding Acknowledgements: The work was supported by Research Council of Lithuania, grant Nr. MIP-049/2015 The work was approved by Lithuanian Bioethics Committee, Nr. L-15- 01.
Introduction: Potassium imbalance is included in some clinical risk scores to assess the prognosis of acute heart failure (AHF) patients. The importance of hypo-/hyperkalemia in prediction of short-term outcomes in a wide population of acute dyspnea patients is less clear. Purpose: We aimed to evaluate the prognostic value of abnormal blood potassium levels in prediction of short-term mortality and readmissions in acute dyspnea patients. Methods: Prospective observational cohort study enrolled consecutive patients admitted to the emergency department with acute dyspnea due to AHF and other reasons. Blood potassium levels at the time of admission and number of deaths and rehospitalizations due to cardiovascular and other reasons in 1 and 3 months of follow up were collected. Data of 45 study patients (mean age 68 years) were included in the analysis. Hypokalemia and hyperkalemia were defined as blood potassium level<3.8 mmol/l and>5.2 mmol/l, respectively. Data were analyzed using SPSS v23 statistical package with binary logistic regression. Results: Of 445 patients (185 female) 101 subjects (22.7%) were hypokalemic, 330 – normokalemic, 14 (3.1%) had hyperkalemia. AHF was diagnosed in 243 patients (54.6%); other diagnoses in 201 (45.2%) remaining participants included atrial fibrillation (7%), exacerbation of COPD/asthma (11.4%), pulmonary embolism (6%), pneumonia (16.4%), acute coronary syndromes (6.2%). Hypo- and hyperkalemia were found in 21.4% and 2.9% of AHF patients. Regardless of the presence of AHF diagnosis hypokalemia was associated with significantly increased risk of 3-month cardiovascular readmissions and 1-month non-cardiovascular readmissions, OR=1.024 (CI 0.998;1.050) and OR=2,189 (CI 1.023;4.686), respectively (p<0.05). Hyperkalemia was a significant predictor of 3-month cardiovascular readmissions with OR=4.489 (CI 1.319;15.274). No significant association of abnormal potassium level with 1- or 3-mo[...].