Peter C Lind, Nikola Stankovic, Mathias J Holmberg, Lars W Andersen, Asger Granfeldt
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引用次数: 0
Abstract
Objectives: Hyperkalemia and hypokalemia are common in admitted patients and recognized as a reversible cause of cardiac arrest. How the risk of in-hospital cardiac arrest changes relative to the severity of hyperkalemia and hypokalemia remains uncertain. The objective of this study was to estimate the association between pre-cardiac arrest hyperkalemia and hypokalemia and in-hospital cardiac arrest and outcomes after in-hospital cardiac arrest.
Setting: Hospitalized patients in Denmark from 2017 to 2021.
Patients: Cases were adults with in-hospital cardiac arrest identified through the Danish in-hospital cardiac arrest Registry. These were matched with controls on age, sex, and length and time of admission. The index time was defined for cases as their time of cardiac arrest. A corresponding index time was assigned to matched controls.
Interventions: None.
Measurements and main results: The exposure was potassium levels within 24 hours of the index time. Outcomes were in-hospital cardiac arrest and return of spontaneous circulation, 30-day survival, and 1-year survival in those with cardiac arrest. A total of 6,658 cases and 49,906 controls were included. Severe hyperkalemia (K+ > 6.5) and hypokalemia (K+ < 2.5) were associated with 2.03 (95% CI, 1.28-3.23) and 2.65 (95% CI, 1.61-4.38) times the odds of in-hospital cardiac arrest compared with normokalemia, respectively. Increasing severity of hyperkalemia was associated with decreased odds of return of spontaneous circulation, 30-day survival, and 1-year survival after in-hospital cardiac arrest. There was no clear association between hypokalemia and these outcomes.
Conclusions: Hyperkalemia was associated with an increased risk of in-hospital cardiac arrest and with worse outcomes after cardiac arrest. Hypokalemia was associated with an increased risk of in-hospital cardiac arrest but was not associated with outcomes after cardiac arrest.
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Critical Care Medicine is the premier peer-reviewed, scientific publication in critical care medicine. Directed to those specialists who treat patients in the ICU and CCU, including chest physicians, surgeons, pediatricians, pharmacists/pharmacologists, anesthesiologists, critical care nurses, and other healthcare professionals, Critical Care Medicine covers all aspects of acute and emergency care for the critically ill or injured patient.
Each issue presents critical care practitioners with clinical breakthroughs that lead to better patient care, the latest news on promising research, and advances in equipment and techniques.
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