Correcting Hypokalemia in Hospitalized Patients Does Not Decrease Risk of Cardiac Arrhythmias

Weston Harkness, Paula J Watts, Michael Kopstein, O. Dziadkowiec, Gregory Hicks, D. Scherbak
{"title":"Correcting Hypokalemia in Hospitalized Patients Does Not Decrease Risk of Cardiac Arrhythmias","authors":"Weston Harkness, Paula J Watts, Michael Kopstein, O. Dziadkowiec, Gregory Hicks, D. Scherbak","doi":"10.1155/2019/4919707","DOIUrl":null,"url":null,"abstract":"Background It is currently standard practice to correct hypokalemia for the purpose of preventing cardiac arrhythmias in all hospitalized patients. However, the efficacy of this intervention has never been previously studied. Objective The objective of our study was to evaluate whether patients without acute coronary syndrome or history of arrhythmias were at increased risk of clinically significant cardiac arrhythmias if their potassium level was not corrected to ≥3.5 mEq/L. Design A retrospective case control study. Setting A community hospital. Participants We enrolled selected patients who had episodes of hypokalemia during their hospital stay and were monitored on telemetry. Patients were split into groups based on success of replacing serum potassium to ≥3.5 mEq/L after 24 hours. Measurements The primary outcome was the development of an arrhythmia. Arrhythmias included supraventricular tachycardia, atrial fibrillation, atrial flutter, Mobitz type II second-degree or third-degree AV block, ventricular tachycardia, or ventricular fibrillation. A one-tailed Fisher's exact test and logistic regression were used for analysis. Results A total of 1338 hypokalemic patient days were recorded. Out of these days, 22 arrhythmia events (1.6% of patient days) were observed, 8 in the uncorrected group (1% patient days) and 14 in the corrected group (2.6% patient days). We found no statistically significant relationship between successfully correcting potassium to ≥3.5 mEq/L and number of arrhythmic events (p=0.037, OR = 2.38 (95% CI: 0.99, 6.03)). Logistic regression revealed that correction of potassium does not seem to be significantly related to arrhythmias (β = 0.869, p=0.0517). Conclusions In the acute care setting, we found that patients with hypokalemia whose potassium level did not correct to ≥3.5 mEq/L were not at increased odds of having an arrhythmia. This study suggests that the common practice of checking and replacing potassium is likely inconsequential.","PeriodicalId":53309,"journal":{"name":"Advances in Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"5","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2019/4919707","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 5

Abstract

Background It is currently standard practice to correct hypokalemia for the purpose of preventing cardiac arrhythmias in all hospitalized patients. However, the efficacy of this intervention has never been previously studied. Objective The objective of our study was to evaluate whether patients without acute coronary syndrome or history of arrhythmias were at increased risk of clinically significant cardiac arrhythmias if their potassium level was not corrected to ≥3.5 mEq/L. Design A retrospective case control study. Setting A community hospital. Participants We enrolled selected patients who had episodes of hypokalemia during their hospital stay and were monitored on telemetry. Patients were split into groups based on success of replacing serum potassium to ≥3.5 mEq/L after 24 hours. Measurements The primary outcome was the development of an arrhythmia. Arrhythmias included supraventricular tachycardia, atrial fibrillation, atrial flutter, Mobitz type II second-degree or third-degree AV block, ventricular tachycardia, or ventricular fibrillation. A one-tailed Fisher's exact test and logistic regression were used for analysis. Results A total of 1338 hypokalemic patient days were recorded. Out of these days, 22 arrhythmia events (1.6% of patient days) were observed, 8 in the uncorrected group (1% patient days) and 14 in the corrected group (2.6% patient days). We found no statistically significant relationship between successfully correcting potassium to ≥3.5 mEq/L and number of arrhythmic events (p=0.037, OR = 2.38 (95% CI: 0.99, 6.03)). Logistic regression revealed that correction of potassium does not seem to be significantly related to arrhythmias (β = 0.869, p=0.0517). Conclusions In the acute care setting, we found that patients with hypokalemia whose potassium level did not correct to ≥3.5 mEq/L were not at increased odds of having an arrhythmia. This study suggests that the common practice of checking and replacing potassium is likely inconsequential.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
纠正住院患者的低钾血症不能降低心律失常的风险
背景纠正低钾血症是目前所有住院患者预防心律失常的标准做法。然而,这种干预的有效性以前从未被研究过。本研究的目的是评估无急性冠状动脉综合征或心律失常史的患者,如果他们的钾水平未校正到≥3.5 mEq/L,是否会增加临床显著性心律失常的风险。设计回顾性病例对照研究。建立社区医院。我们招募了一些在住院期间发生过低血钾发作的患者,并进行了遥测监测。根据24小时后将血清钾置换至≥3.5 mEq/L的成功与否将患者分为两组。主要结果为心律失常的发生。心律失常包括室上性心动过速、心房颤动、心房扑动、Mobitz II型二度或三度房室传导阻滞、室性心动过速或心室颤动。采用单尾Fisher精确检验和logistic回归进行分析。结果共记录1338例低钾患者日。在这些天中,观察到22例心律失常事件(1.6%患者日),未纠正组8例(1%患者日),纠正组14例(2.6%患者日)。我们发现成功校正钾≥3.5 mEq/L与心律失常事件数之间无统计学意义的关系(p=0.037, OR = 2.38 (95% CI: 0.99, 6.03))。Logistic回归分析显示,校正钾与心律失常无显著相关性(β = 0.869, p=0.0517)。结论:在急性护理环境中,我们发现低钾血症患者的钾水平没有纠正到≥3.5 mEq/L,发生心律失常的几率没有增加。这项研究表明,检查和补充钾的常见做法可能是无关紧要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
5
审稿时长
22 weeks
期刊最新文献
Assessment of Knowledge and Attitude of General Practitioners Regarding Autism and Associated Factors at Gondar University Hospital, Gondar, Ethiopia. Influence of Staphylococcus aureus Infection on Partially Ischemic Excisional Skin Wounds. Impact of Obesity on Cardiac Volumes and Left Ventricular Diameter: A Cross-Sectional Study in an Iranian Heart Center. The Epidemiology of COVID-19 Vaccine-Induced Myocarditis Emerging Challenges in Staphylococcus aureus Bloodstream Infections: Insights from Coagulase Typing, Toxin Genes, and Antibiotic Resistance Patterns.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1