Serum potassium as a predictor of adverse clinical outcomes in patients with increasing comorbidity burden
© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology..
AIMS: The aim of this study was to establish whether patients with multiple comorbidities may be at elevated risk of hyperkalaemia (HK), a potentially life-threatening electrolyte imbalance, and the associated adverse clinical outcomes.
METHODS AND RESULTS: This was a retrospective, observational cohort study using UK primary and secondary care data. Adult patients with at least one of: resistant hypertension, chronic kidney disease stage 3+, dialysis, heart failure (HF), and diabetes, were eligible for inclusion. According to their diagnoses, patients were grouped into overlapping cohorts that were updated as multimorbidity progressed. Outcomes of interest were incident HK, all-cause mortality (ACM), and major adverse cardiovascular events (MACE). A total of 673 686 patients met the eligibility criteria, 36.3% of whom developed multimorbidity during the study period. A consistent U-shaped association was observed between serum K+ level and adjusted incidence of ACM and MACE. Hyperkalaemia was progressively more common with increasing Charlson Comorbidity Index (CCI). Relative to a CCI <3, scores of ≥3 to <6, and ≥6 were associated with 2.9- and 6.2-fold increases, respectively, in crude HK (serum K+ ≥5.0 mmol/L) incidence rate. In all condition-based cohorts except for HF, there was a clear correlation between increasing CCI and the risk of ACM and MACE associated with hypokalaemia and HK.
CONCLUSION: Patients with a higher CCI are at an increased risk of developing HK and appear more prone to adverse clinical outcomes associated with abnormal serum K+ levels, warranting additional routine clinical monitoring.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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Enthalten in: |
European heart journal. Quality of care & clinical outcomes - 8(2022), 1 vom: 05. Jan., Seite 61-69 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Tafesse, Eskinder [VerfasserIn] |
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Links: |
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Themen: |
Comorbidity |
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Anmerkungen: |
Date Completed 29.03.2022 Date Revised 01.04.2022 published: Print Citation Status MEDLINE |
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doi: |
10.1093/ehjqcco/qcaa078 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM31648458X |
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520 | |a © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. | ||
520 | |a AIMS: The aim of this study was to establish whether patients with multiple comorbidities may be at elevated risk of hyperkalaemia (HK), a potentially life-threatening electrolyte imbalance, and the associated adverse clinical outcomes | ||
520 | |a METHODS AND RESULTS: This was a retrospective, observational cohort study using UK primary and secondary care data. Adult patients with at least one of: resistant hypertension, chronic kidney disease stage 3+, dialysis, heart failure (HF), and diabetes, were eligible for inclusion. According to their diagnoses, patients were grouped into overlapping cohorts that were updated as multimorbidity progressed. Outcomes of interest were incident HK, all-cause mortality (ACM), and major adverse cardiovascular events (MACE). A total of 673 686 patients met the eligibility criteria, 36.3% of whom developed multimorbidity during the study period. A consistent U-shaped association was observed between serum K+ level and adjusted incidence of ACM and MACE. Hyperkalaemia was progressively more common with increasing Charlson Comorbidity Index (CCI). Relative to a CCI <3, scores of ≥3 to <6, and ≥6 were associated with 2.9- and 6.2-fold increases, respectively, in crude HK (serum K+ ≥5.0 mmol/L) incidence rate. In all condition-based cohorts except for HF, there was a clear correlation between increasing CCI and the risk of ACM and MACE associated with hypokalaemia and HK | ||
520 | |a CONCLUSION: Patients with a higher CCI are at an increased risk of developing HK and appear more prone to adverse clinical outcomes associated with abnormal serum K+ levels, warranting additional routine clinical monitoring | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Observational Study | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 4 | |a Comorbidity | |
650 | 4 | |a Hyperkalaemia | |
650 | 4 | |a Major adverse cardiovascular events | |
650 | 4 | |a Mortality | |
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700 | 1 | |a Badora, Karolina |e verfasserin |4 aut | |
700 | 1 | |a Qin, Lei |e verfasserin |4 aut | |
700 | 1 | |a James, Glen |e verfasserin |4 aut | |
700 | 1 | |a McEwan, Phil |e verfasserin |4 aut | |
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