Prevalence and clinical outcomes of pathological potassium levels (hyperpotessemia and hypopotessemia) in patients presented to emergency departments

Prevalence and Clinical Outcomes of Pathological Potassium Levels (Hyperpotessemia and Hypopotessemia) in Patients Presented to Emergency Departments Introduction: Potassium abnormalities (hypopotassemia-hyperpotassemia) is a common clinical condition among patients presented to Emergency Departments with various complaints and symptoms. Potassium is an electrolyte that is of vital importance in fulfillment of cell functions. Potassium must be present at a certain concentration (3.5-5 mEq/L) in blood. Serum potassium levels that are outside of these values are defined as "serum potassium abnormality". To date, there have been limited data on the epidemiology and clinical outcomes of these highly critical patients. Aim: This descriptive study has been planned to analyze the information about the prevalence, mortality, demographic features of patients presented to Emergency Department with potassium abnormality. Method: This study* has been designed as a descriptive clinical study. Among patients who applied to the Emergency Department of Akdeniz University Hospital in the period between 01.01.2016 and 31.12.2016, the ones who were detected with potassium abnormality were included in the study. The data pool has been built by scanning the electronic medical records of patients included in the study through the "MiaMed Hospital Information Management System" of Akdeniz University Hospital. The patients' survival condition and the information of time of death is detected by inquiring the "Death Notification System of Public Health General Directorate of Ministry of Health of Turkish Republic". Results: In a year period, 18582 serum potassium samples were evaluated. 4017 (21,6%) of these samples were detected with potassium abnormality. 535 (2,87%) samples detected as pseudohyperpotassemia were excluded from the study. On the study, 363 (9%) results were excluded as these were duplicate samples. The total number of 3091 (16,6%) results consisted of 1177 (6,3%) hypopotassemia samples and 1934 (10,4%) hyperpotassemia samples formed the dataset. 48,5% of patients in the study were female. Mean age of the patients was 61,6 (SD: 18,94). Median serum potassium level of patients with hyperpotassemia was 5,40 mEq/L, median serum potassium level of patients with hypopotassemia was 3,33 mEq/L. AKI was detected in 15,4%, and CKD was detected in 20% of the patients with hyperpotassemia; 11,3% of these patients underwent dialysis. It has been seen that the 7-day, 28-day and 1-year mortality of patients with hyperpotassemia and hypopotassemia were similar. It has been found that the frequency of AKI, hemodialysis, and hospital admission rate are statistically significant and higher in all patient groups who had potassium abnormalities and died within 7 days, 28 days and one year. When the patients in whom hyperpotassemia was detected and who died within a year were analyzed, it was seen that the mortality rates are also high in patients whose serum potassium levels were closer to normal values. Conclusion: As a conclusion, it has been found that pseudohyperpotassemia is a frequently encountered condition; hyperpotassemia is associated with hospital admissions, mortality, and hemodialysis; in patients with hypopotassemia, underlying causes of this condition except for renal disorders can be of significance for prognosis; the mortality rates are also high in patients with serum potassium levels close to upper limit of normal. We think that all the patients who are detected with potassium abnormality should be closely monitored.