Abstract 16662: Association of Potassium Values in Hospitalized Patients With Mortality: Data From a Metropolitan Safety-net Hospital
Introduction: Extremes of serum potassium (K) levels have been associated with adverse outcomes. We examined the association between K values with mortality in patients hospitalized at a metropolitan safety-net hospital.
Methods: We obtained K values for all patients hospitalized over a 1-yr period (July 2014-June 2015) and analyzed the association between K level and in-hospital mortality. We also assessed the % of patients with K > 5.0 by race and comorbidity: Diabetes Mellitus (DM), Chronic Kidney Disease (CKD), and Congestive Heart Failure (CHF).
Results: 17,317 hospitalizations with K values were included. The mean age was 50.2 yrs, 57.3% of patients were male, 47.7% white, 33.7% black; for comorbidities, 25.9% had DM, 14.1% CKD, and 6.2% CHF. The distribution of K <3.5, 3.5-<5, 5-<6, and 6+, was 7.9%, 88.7%, 3.1%, 0.3%, respectively. There was a U-shaped relationship between K and mortality, with the lowest risk between 3.5 and 5.0 mEg/L. The % of patients with K > 5.0 for patients with DM was 4.0%, CKD 6.4%, CHF 6.0%, compared to 0.9% among patients without any of the three comorbidities (all p < 0.001). By race, the % with K > 5.0 for White, Black, and other race was 2.0%, 3.3% and 2.8%, respectively (p < 0.001).
Conclusions: Although both low and high K values were associated with an increased risk of mortality, risk of death increased once potassium exceeded 5.5 mEq/L and increased markedly thereafter. The comorbid conditions of DM, CKD, and CHF are all associated with increased serum K levels, and there were differences by race. Additional interventions to prevent severe hyperkalemia in pts with DM, CKD, and CHF may be appropriate.
Author Disclosures: C.A. Herzog: Research Grant; Significant; Amgen, Zoll. Honoraria; Modest; UpToDate. Ownership Interest; Modest; Boston Scientific, GE, Johnson & Johnson, Merck. Consultant/Advisory Board; Modest; AbbVie, BMS, Davita Clinical Research, Relypsa, ZS Pharma. Consultant/Advisory Board; Significant; FibroGen. J.B. Wetmore: None. W.L. St. Peter: None. D.T. Gilbertson: Consultant/Advisory Board; Modest; DaVita Clinical Research.
- © 2016 by American Heart Association, Inc.