Journal of the colleges of medicine of South Africa最新文献

{"title":"What's in a number: Falling on the sword of cut-off points and reference limits?","authors":"Verena Gounden, Nareshni Moodley","doi":"10.4102/jcmsa.v3i1.148","DOIUrl":"10.4102/jcmsa.v3i1.148","url":null,"abstract":"<p><p>The marked increase in laboratory test volumes and costs internationally emphasises the need for demand management. One way that this can be implemented is by reducing unnecessary repeat testing with the provision of appropriate decision cut-off points (clinical decision limits [CDLs]) or reference intervals (RIs) with subsequent correct interpretation of laboratory results. The derivation of RIs and CDLs are fraught with technical and biological challenges. There is difficulty in conducting labour-intensive, costly, long, and complex studies, which require healthy volunteers that represent things such as different age groups, genders, races, and alternate states of health (e.g. pregnancy) within the population. It is also inappropriate to apply RIs or cut-off points from other populations, which is often what occurs when manufacturer-expected values are used. Lack of standardisation of international guidelines for CDLs and analytical methods poses a further problem. The effect of analytical and biological variation on results is also essential to consider when interpreting results. These make ideal RIs and CDLs difficult to attain and implement despite their critical need.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"148"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'We're getting there': Registrar and examiner perspectives on structured oral examinations in emergency medicine.","authors":"Sa'ad Lahri, Rhoda Meyer","doi":"10.4102/jcmsa.v3i1.206","DOIUrl":"10.4102/jcmsa.v3i1.206","url":null,"abstract":"<p><strong>Background: </strong>Structured oral examinations (SOEs) are essential for assessing clinical competence in postgraduate emergency medicine qualifications. The rapid shift to web-based SOEs during the coronavirus disease 2019 pandemic and their continued use warrants an exploration of their effectiveness to identify areas for improvement in high-stakes assessments.</p><p><strong>Methods: </strong>A qualitative, exploratory approach situated within an interpretivist paradigm was used to explore the perspectives of registrars and examiners who had participated in a recent web-based Fellowship of the College of Emergency Medicine Part II examination in South Africa. Six registrars and seven examiners participated in semi-structured interviews. Reflexive thematic analysis, guided by Braun and Clarke's approach, was used to identify key themes from the data.</p><p><strong>Results: </strong>Participants recognised the value of SOEs in assessment but also highlighted areas for improvement. Concerns included misalignment between exam content and clinical reasoning, anxiety because of the high-stakes nature of the assessment and familiarity with examiners and challenges faced by non-native English speakers. Examiners recommended targeted training in question design and bias mitigation.</p><p><strong>Conclusion: </strong>Enhancing SOEs through better examiner training and bias mitigation will strengthen their effectiveness. Integrating workplace-based assessment (WBAs) will reduce reliance on SOEs, promoting a more comprehensive approach to assessment in emergency medicine.</p><p><strong>Contribution: </strong>This study offers practical recommendations for improving examiner training, design and fairness in SOEs. Integrating WBAs with SOEs supports continuous, real-world assessment of competence. Bias-awareness training enhances equity, enabling institutions to design fairer, inclusive assessments.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"206"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring factors underlying the use of nyaope in Tshwane, South Africa: A qualitative study.","authors":"Doudou K Nzaumvila, Robert Mash, Toby Helliwell","doi":"10.4102/jcmsa.v3i1.129","DOIUrl":"10.4102/jcmsa.v3i1.129","url":null,"abstract":"<p><strong>Background: </strong>Nyaope increasing use has become a major public health concern, not only because of its detrimental health effects but also because of its far-reaching social consequences. This situation has caused distress for families, communities and the users themselves, contributing to ongoing cycles of dependency and instability at the social, family and individual levels. The aim of this study is to explore the perspectives of users regarding the factors underlying their use of and dependency on nyaope.</p><p><strong>Methods: </strong>An exploratory descriptive qualitative design was employed. Data were gathered from 10 nyaope users through semi-structured interviews.</p><p><strong>Results: </strong>Nyaope was widely and easily available, and purchases could be made with impunity. Factors such as peer pressure, boredom, poverty, unemployment and escapism all contributed to the initiation of nyaope use. Participants financed their habit through personal earnings, criminal activities and even support from family members. There was a pervasive sense of lawlessness associated with nyaope use, coupled with the stigmatisation and marginalisation of users by both their families and communities. Many users ultimately became part of a street-level nyaope brotherhood that perpetuated the use.</p><p><strong>Conclusion: </strong>Multisectoral and multifaceted interventions will be necessary to reduce the use of nyaope. Further research could quantify these factors and inform more effective prevention and treatment strategies.</p><p><strong>Contribution: </strong>These findings, along with input from community and family members, provide a comprehensive understanding of the factors related to nyaope use.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"129"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experiences of WALANT for outpatient upper limb surgery: A cross-sectional study of perioperative pain and anxiety.","authors":"Reshlan Govender, Antoine G L Rocher, Mario T Rankin, Khangelani Sondovana, Simphiwe C Phenyane, Megan O'Connor","doi":"10.4102/jcmsa.v3i1.184","DOIUrl":"10.4102/jcmsa.v3i1.184","url":null,"abstract":"<p><strong>Background: </strong>Demands on South African operating theatres have led to more outpatient upper limb surgery being performed under wide awake local anaesthesia no tourniquet (WALANT). This study aimed to determine patients' anxiety and pain related to WALANT use in outpatient upper limb surgery, and to identify factors that increased the risk of heightened pain experiences.</p><p><strong>Methods: </strong>This multicentre cross-sectional study conducted between December 2022 and June 2024 utilised the 'strengthening the reporting of observational studies in epidemiology guidelines'. Patients receiving outpatient upper limb surgery under WALANT were prospectively recruited for participation in an investigator-administered questionnaire of 15 questions regarding their demographics, procedure, anxiety and pain experiences. Patients' anxiety and pain experiences were summarised, and relationships between demographic or procedural factors and anxiety or pain scores were tested.</p><p><strong>Results: </strong>In all, 85 patients were included. The most frequent procedures performed were tendon repairs and trigger releases (42% and 12% respectively). Of the total recruited patients, 45% reported moderate to severe anxiety perioperatively. The median visual analogue scale (VAS) score for pain of injection and procedure were 20 mm and 0 mm, respectively. Male patients and isiZulu speaking patients had lower VAS pain scores, while very anxious patients had higher VAS pain scores.</p><p><strong>Conclusion: </strong>Forty-five per cent of patients who underwent outpatient upper limb surgery under WALANT experienced perioperative anxiety. They did not experience the anaesthetic or surgery as painful on average. Pain scores were related to perioperative anxiety. Future investigation should further explore the relationship between perioperative anxiety and pain.</p><p><strong>Contribution: </strong>Wide awake local anaesthesia no tourniquet is well tolerated in patients undergoing outpatient upper limb surgery.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"184"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sevoflurane usage and fresh gas flows in Maquet anaesthetic machines at an academic hospital.","authors":"Aobakwe R Setlhare, Kylesh D Pegu, Mathabe Sehlapelo","doi":"10.4102/jcmsa.v3i1.170","DOIUrl":"10.4102/jcmsa.v3i1.170","url":null,"abstract":"<p><strong>Background: </strong>Low-flow anaesthesia (LFA) is crucial in combating rising healthcare costs and the global threat of climate change. This study analysed the conduct of inhalational anaesthesia at a Johannesburg Academic Hospital to determine fresh gas flows (FGF) and liquid agent consumption (LAC) at various stages of anaesthesia.</p><p><strong>Methods: </strong>A prospective, contextual research design was followed. Purposive sampling method was used in 10 theatres equipped with Maquet Flow-i® anaesthetic machines. Calculated LAC values were compared to those measured by the anaesthetic machines.</p><p><strong>Results: </strong>The average FGF during induction, maintenance and time-weighted case average were 7.07 L/min, 1.41 L/min and 1.73 L/min, respectively. The average end-tidal sevoflurane concentration during maintenance was 2.40%. The calculated average LAC for induction, maintenance and total case were 7.74 mL, 28.01 mL and 36.84 mL, respectively, while the hourly LAC was 16.71 mL/h. The calculated case average LAC overestimated the measured values by 4.14 ± 4.86 mL (12.98%), with 98.5% of values being within ± 1.96 standard deviation (s.d.). Despite its brevity, the induction phase accounted for 21% of the calculated LAC. The calculated liquid agent expenditure over time was ZAR54.32 ± 23.55/h. Case average FGF had a very high positive correlation with the calculated cost of sevoflurane, <i>r</i> = 0.86, <i>p</i> < 0.001.</p><p><strong>Conclusion: </strong>This study demonstrated that the prevailing use of medium-flow anaesthesia among anaesthetists at our institution resulted in significant sevoflurane wastage, increased expenditure and environmental pollution.</p><p><strong>Contribution: </strong>The study provides insight into anaesthesia practices at an academic hospital. It highlights the need to implement policies to standardise LFA as a cost-saving and environmentally friendly strategy.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"170"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dawdle, dally and delay of diabetic ketoacidosis: Decoding the emergency department length of stay - A chart review.","authors":"Raees Gangat, Nicholas J Dufourq, Duncan M Havenga","doi":"10.4102/jcmsa.v3i1.200","DOIUrl":"10.4102/jcmsa.v3i1.200","url":null,"abstract":"<p><strong>Background: </strong>Diabetic ketoacidosis is a life-threatening complication requiring prompt intervention. Understanding factors influencing the duration of emergency department (ED) stay is essential for optimising patient care and resource utilisation.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients diagnosed with diabetic ketoacidosis at a regional hospital in KwaZulu-Natal between March 2022 and March 2023. Demographics, precipitants, severity, potassium levels and time to resolution were analysed to determine correlations between these variables and the duration of stay in the ED.</p><p><strong>Results: </strong>Of the 156 records, 105 met the inclusion criteria. The mean age was 36.8 years, with 51.4% male and 98.1% of black ethnicity. Poor compliance (37.1%) and infection (31.4%) were the commonest precipitants. Longer durations in the ED (16.2 h, <i>p</i> = 0.007) were linked to cases with unknown precipitants. The median stay was 6 h-12 h, with infection linked to the longest mean duration (10.1 h). Recurrent episodes occurred in 38.1% of patients. Severe diabetic ketoacidosis (13.0 hours, <i>p</i> = 0.001) and a lower pH at presentation (<i>β</i> = -19.6, <i>p</i> < 0.001) were significantly associated with prolonged time to resolution. Potassium abnormalities (29.5%) had no significant effect on duration of stay (<i>p</i> = 0.775).</p><p><strong>Conclusion: </strong>Unknown precipitants significantly influenced the length of stay in the ED. Infection, severe acidosis, and hypokalaemia contributed with variable significance, highlighting that targeted interventions may potentially reduce congestion in these settings.</p><p><strong>Contribution: </strong>This study provides valuable insights into factors influencing ED length of stay for diabetic ketoacidosis patients, offering evidence to improve clinical management and resource allocation in regional hospitals.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"200"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proficiency of South African intern doctors in recognising ischaemia on an electrocardiogram.","authors":"Relisha K Naidoo, Duncan M Havenga, David Morris","doi":"10.4102/jcmsa.v3i1.190","DOIUrl":"10.4102/jcmsa.v3i1.190","url":null,"abstract":"<p><strong>Background: </strong>Interpreting an electrocardiogram (ECG) is challenging for junior doctors, and proficiency gaps exist commonly worldwide. This study assessed interpretation accuracy and self-confidence of South African intern doctors in identifying acute myocardial ischaemia on an ECG and analysed the impact of an education strategy.</p><p><strong>Methods: </strong>This descriptive, quantitative study included a prospective analytical component using a standardised teaching session. All participants completed an ECG interpretation test and self-confidence questionnaire both before and after the teaching session. Descriptive statistics summarised demographics; data analyses included means, medians, modes, and individualised comparisons of pre- and post-teaching test scores and self-confidence.</p><p><strong>Results: </strong>One hundred and sixty-four interns were analysed. At baseline, interns demonstrated above-average accuracy (mean test score 60.1%) and most declared moderate insecurity with ECG interpretation. Post-teaching, accuracy improved marginally (mean test score 65.8%) (<i>p</i> < 0.001), and self-confidence improved drastically with most becoming moderately confident (<i>p</i> < 0.001). However, while there was a significant improvement in the recognition of four ischaemic and two non-ischaemic ECG patterns, the misinterpretation of one non-ischaemic ECG significantly worsened, and there was an insignificant impact on half of the ischaemic ECGs tested.</p><p><strong>Conclusion: </strong>Interns demonstrated above-average accuracy in identifying acute myocardial ischaemia on an ECG with moderate insecurity at baseline. While a teaching session improved self-confidence, its impact on accuracy was mixed. This highlights a need for ongoing training of South African intern doctors in ECG interpretation.</p><p><strong>Contribution: </strong>This study was the first to assess ECG interpretation accuracy and associated self-confidence of South African intern doctors, thereby offering a local perspective on this essential skill.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"190"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 'modified' keystone flap in a single-surgeon case series: A new design in 32 patients.","authors":"Samuel J Isaacs, Saleigh Adams","doi":"10.4102/jcmsa.v3i1.189","DOIUrl":"10.4102/jcmsa.v3i1.189","url":null,"abstract":"<p><strong>Introduction: </strong>The keystone island flap was described in 2003 by Dr Felix Behan. The design is a curvilinear, trapezoidal random perforator island flap with 4 classic subtypes (I-IV). It was named 'keystone' as it is identical in shape to the central pillar (keystone) used in architecture. It has shown its versatility in the closure of complex skin defects and wounds as an alternative to skin grafts and other reconstruction options (pedicled, transposition or rotation-advancement flaps). This case series reviews the practical design, use and applications of a 'modified flap'. The key modification is the use of only lateral limb fasciotomy incisions to the keystone flap.</p><p><strong>Patients’ presentation: </strong>A retrospective single-surgeon case series (32 patients), each of whom underwent the 'modified' technique. Data were obtained from folder review on consenting adults who underwent surgery (01 January 2018 to 01 January 2022). Permission was obtained telephonically, and data were captured in a standardised sheet and electronically. Approval was granted by the ethical review board.</p><p><strong>Management and outcome: </strong>Defects (4 cm² - 72 cm²) were reconstructed in adults (21-94 years). The most common site was the lower limb (23/32). There were two minor cases of epidermolysis and no flap loss (100% success rate).</p><p><strong>Conclusion: </strong>The 'modified' keystone flap is versatile and reliable with applications in multiple sites as a reconstructive tool.</p><p><strong>Contribution: </strong>The authors propose a modification to the existing system to include a Type IIC with the 'modified' design.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"189"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile of self-harming patients admitted in a South African hospital.","authors":"Mohale V Senyolo, Indiran Govender, Tombo Bongongo","doi":"10.4102/jcmsa.v3i1.114","DOIUrl":"10.4102/jcmsa.v3i1.114","url":null,"abstract":"<p><strong>Background: </strong>Self-harm, as intentionally hurting oneself, has grown to be a major public health issue in recent years. Such act can be carried out without the deliberate intent to kill oneself. This study aimed to profile self-harming patients admitted to a South African hospital.</p><p><strong>Methods: </strong>A cross-sectional design based on retrospective record review of self-harming patients between June 2022 and May 2023 at Dr George Mukhari Academic Hospital (DGMAH).</p><p><strong>Results: </strong>Out of 223 records retrieved, the participants' mean age was 24.6 years. Their ages ranged from 13 years to 75 years. The majority were single (<i>n</i> = 198; 89.56%), unemployed (<i>n</i> = 103; 46.19%) and did not have any comorbidities (<i>n</i> = 171; 76.68%). Human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) (<i>n</i> = 19; 8.52%) was the most common comorbidity. Overdose and poisoning (<i>n</i> = 220; 98.65%) are common methods utilised, and with high rate happened in October (<i>n</i> = 39; 17.65%). The most common reasons were interpersonal, including family conflict (69; 30.80%) and relationship issues (<i>n</i> = 61; 27.23%). Age was linked with sex, comorbidities, method and reason (<i>p</i> = 0.008). Conflict was linked with females and relationship problems with males (<i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>Self-harm is common among single females under 40 years, often because of romantic and family conflicts. Age and sex influence risk, with younger females using over-the-counter medication, older females with retroviral diseases using prescriptions. Further research, including prevention, may assist in the management of the behavior.</p><p><strong>Contribution: </strong>An alarming and growing public health risk has been raised.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"114"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of hyperkalaemia with electrocardiographic changes at a tertiary centre in South Africa.","authors":"Francis R Ssenabulya, Mogamat-Yazied Chothia","doi":"10.4102/jcmsa.v3i1.110","DOIUrl":"10.4102/jcmsa.v3i1.110","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalaemia is a common electrolyte disorder in hospitalised patients and is associated with fatal cardiac arrhythmias. In sub-Saharan Africa, there is a paucity of data regarding the prevalence and type of electrocardiographic (ECG) changes in patients who have hyperkalaemia.</p><p><strong>Methods: </strong>A retrospective descriptive study was conducted at Tygerberg Hospital over a one-year period in 2019. Adult patients with hyperkalaemia of ≥ 5.5 mmol/L and associated ECG changes 3 h before or after documented laboratory hyperkalaemia were included. Spearman correlation coefficients and multilinear regression were used to identify correlations and associations, respectively, between serum potassium concentrations ([K⁺]) and various ECG changes.</p><p><strong>Results: </strong>Of 344 patients who had hyperkalaemia and an associated ECG, 55% had ECG changes. These patients were older (60 years vs. 53 years, <i>p</i> = 0.01), male (57% vs. 43%, <i>p</i> < 0.01) and had more frequent kidney disease (88% vs. 78%, <i>p</i> = 0.02). Statistically significant differences in all ECG measurements were present, except for <i>T</i> wave amplitude. The most frequent ECG alterations were <i>p</i>-wave abnormalities (52%) and peaked <i>T</i> waves (45%). A weak-to-moderate correlation was present for the number of ECG changes and the [K⁺]. The QRS duration (<i>β</i>: 0.0076, <i>p</i> < 0.001), PR interval (<i>β</i>: 0.0039, <i>p</i> < 0.001) and <i>p</i> wave duration (<i>β</i>: -0.0056, <i>p</i> < 0.01) were associated with the [K⁺].</p><p><strong>Conclusion: </strong>The overall prevalence of ECG changes due to hyperkalaemia was only 55%.</p><p><strong>Contribution: </strong>It is essential for clinicians to recognise that the ECG changes during hyperkalaemia may have limited screening value.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}