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Serum Potassium Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients

Background and Objectives: The optimal range of serum potassium at hospital discharge is unclear. The aim of this study was to assess the relationship between discharge serum potassium levels and one-year mortality in hospitalized patients. Materials and Methods: All adult hospital survivors between...

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Autores principales: Thongprayoon, Charat, Cheungpasitporn, Wisit, Thirunavukkarasu, Sorkko, Petnak, Tananchai, Chewcharat, Api, Bathini, Tarun, Vallabhajosyula, Saraschandra, Mao, Michael A., Erickson, Stephen B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279137/
https://www.ncbi.nlm.nih.gov/pubmed/32423140
http://dx.doi.org/10.3390/medicina56050236
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author Thongprayoon, Charat
Cheungpasitporn, Wisit
Thirunavukkarasu, Sorkko
Petnak, Tananchai
Chewcharat, Api
Bathini, Tarun
Vallabhajosyula, Saraschandra
Mao, Michael A.
Erickson, Stephen B.
author_facet Thongprayoon, Charat
Cheungpasitporn, Wisit
Thirunavukkarasu, Sorkko
Petnak, Tananchai
Chewcharat, Api
Bathini, Tarun
Vallabhajosyula, Saraschandra
Mao, Michael A.
Erickson, Stephen B.
author_sort Thongprayoon, Charat
collection PubMed
description Background and Objectives: The optimal range of serum potassium at hospital discharge is unclear. The aim of this study was to assess the relationship between discharge serum potassium levels and one-year mortality in hospitalized patients. Materials and Methods: All adult hospital survivors between 2011 and 2013 at a tertiary referral hospital, who had available admission and discharge serum potassium data, were enrolled. End-stage kidney disease patients were excluded. Discharge serum potassium was defined as the last serum potassium level measured within 48 h prior to hospital discharge and categorized into ≤2.9, 3.0–3.4, 3.5–3.9, 4.0–4.4, 4.5–4.9, 5.0–5.4 and ≥5.5 mEq/L. A Cox proportional hazards analysis was performed to assess the independent association between discharge serum potassium and one-year mortality after hospital discharge, using the discharge potassium range of 4.0–4.4 mEq/L as the reference group. Results: Of 57,874 eligible patients, with a mean discharge serum potassium of 4.1 ± 0.4 mEq/L, the estimated one-year mortality rate after discharge was 13.2%. A U-shaped association was observed between discharge serum potassium and one-year mortality, with the nadir mortality in the discharge serum potassium range of 4.0–4.4 mEq/L. After adjusting for clinical characteristics, including admission serum potassium, both discharge serum potassium ≤3.9 mEq/L and ≥4.5 mEq/L were significantly associated with increased one-year mortality, compared with the discharge serum potassium of 4.0–4.4 mEq/L. Stratified analysis based on admission serum potassium showed similar results, except that there was no increased risk of one-year mortality when discharge serum potassium was ≤3.9 mEq/L in patients with an admission serum potassium of ≥5.0 mEq/L. Conclusion: The association between discharge serum potassium and one-year mortality after hospital discharge had a U-shaped distribution and was independent of admission serum potassium. Favorable survival outcomes occurred when discharge serum potassium was strictly within the range of 4.0–4.4 mEq/L.
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spelling pubmed-72791372020-06-15 Serum Potassium Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients Thongprayoon, Charat Cheungpasitporn, Wisit Thirunavukkarasu, Sorkko Petnak, Tananchai Chewcharat, Api Bathini, Tarun Vallabhajosyula, Saraschandra Mao, Michael A. Erickson, Stephen B. Medicina (Kaunas) Article Background and Objectives: The optimal range of serum potassium at hospital discharge is unclear. The aim of this study was to assess the relationship between discharge serum potassium levels and one-year mortality in hospitalized patients. Materials and Methods: All adult hospital survivors between 2011 and 2013 at a tertiary referral hospital, who had available admission and discharge serum potassium data, were enrolled. End-stage kidney disease patients were excluded. Discharge serum potassium was defined as the last serum potassium level measured within 48 h prior to hospital discharge and categorized into ≤2.9, 3.0–3.4, 3.5–3.9, 4.0–4.4, 4.5–4.9, 5.0–5.4 and ≥5.5 mEq/L. A Cox proportional hazards analysis was performed to assess the independent association between discharge serum potassium and one-year mortality after hospital discharge, using the discharge potassium range of 4.0–4.4 mEq/L as the reference group. Results: Of 57,874 eligible patients, with a mean discharge serum potassium of 4.1 ± 0.4 mEq/L, the estimated one-year mortality rate after discharge was 13.2%. A U-shaped association was observed between discharge serum potassium and one-year mortality, with the nadir mortality in the discharge serum potassium range of 4.0–4.4 mEq/L. After adjusting for clinical characteristics, including admission serum potassium, both discharge serum potassium ≤3.9 mEq/L and ≥4.5 mEq/L were significantly associated with increased one-year mortality, compared with the discharge serum potassium of 4.0–4.4 mEq/L. Stratified analysis based on admission serum potassium showed similar results, except that there was no increased risk of one-year mortality when discharge serum potassium was ≤3.9 mEq/L in patients with an admission serum potassium of ≥5.0 mEq/L. Conclusion: The association between discharge serum potassium and one-year mortality after hospital discharge had a U-shaped distribution and was independent of admission serum potassium. Favorable survival outcomes occurred when discharge serum potassium was strictly within the range of 4.0–4.4 mEq/L. MDPI 2020-05-14 /pmc/articles/PMC7279137/ /pubmed/32423140 http://dx.doi.org/10.3390/medicina56050236 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Thongprayoon, Charat
Cheungpasitporn, Wisit
Thirunavukkarasu, Sorkko
Petnak, Tananchai
Chewcharat, Api
Bathini, Tarun
Vallabhajosyula, Saraschandra
Mao, Michael A.
Erickson, Stephen B.
Serum Potassium Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title Serum Potassium Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_full Serum Potassium Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_fullStr Serum Potassium Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_full_unstemmed Serum Potassium Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_short Serum Potassium Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_sort serum potassium levels at hospital discharge and one-year mortality among hospitalized patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279137/
https://www.ncbi.nlm.nih.gov/pubmed/32423140
http://dx.doi.org/10.3390/medicina56050236
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