Table 2.
Comparison of clinical characteristics among patients with mild, moderate, and severe hyperkalemia during the ED visit
| Mild hyperkalemia | Moderate hyperkalemia | Severe hyperkalemia | p values | ||
|---|---|---|---|---|---|
| > 5.0–5.5 mEq/L | > 5.5–6.0 mEq/L | > 6.0 mEq/L | Mild vs. moderate | Mild vs. severe | |
| (N = 4432) | (N = 1085) | (N = 705) | |||
| Death during ED visit, n (%) | |||||
| Patients who died | 50 (1.1%) | 40 (3.7%) | 75 (10.6%) | < 0.001 | < 0.001 |
| Potassium lab values during ED visit | |||||
| Number of potassium lab values, mean (SD) | 1.2 (0.5) | 1.5 (0.9) | 2.2 (1.4) | < 0.001 | < 0.001 |
| Patients with ≥ 2 potassium lab values, n (%) | 663 (15.0%) | 438 (40.4%) | 532 (75.5%) | < 0.001 | < 0.001 |
| Among patients with ≥ 2 lab values | |||||
| First potassium lab value, mean (SD) | 5.3 (0.1) | 5.8 (0.1) | 6.7 (0.8) | < 0.001 | < 0.001 |
| Last potassium lab value, mean (SD) | 4.8 (0.6) | 4.8 (0.7) | 4.9 (1.0) | 0.96 | < 0.001 |
| Potassium lab value returned to ≤ 5.0 mEq/L by the end of the visit, n (%) | 396 (59.7%) | 287 (65.5%) | 304 (57.1%) | 0.06 | 0.4 |
| Monitoring during ED visit, n (%) | |||||
| Electrocardiograma | 2151 (56.5%) | 646 (69.6%) | 532 (81.0%) | < 0.001 | < 0.001 |
| Treatment during ED visit, n (%) | |||||
| Any treatment | 592 (13.4%) | 334 (30.8%) | 322 (45.7%) | < 0.001 | < 0.001 |
| Any temporizing agent | 248 (5.6%) | 168 (15.5%) | 223 (31.6%) | < 0.001 | < 0.001 |
| Albuterol | 185 (4.2%) | 84 (7.7%) | 103 (14.6%) | < 0.001 | < 0.001 |
| Calcium | 53 (1.2%) | 74 (6.8%) | 134 (19.0%) | < 0.001 | < 0.001 |
| Insulin with glucose IV | 31 (0.7%) | 76 (7.0%) | 123 (17.4%) | < 0.001 | < 0.001 |
| Sodium bicarbonate IV | 44 (1.0%) | 49 (4.5%) | 97 (13.8%) | < 0.001 | < 0.001 |
| SPS | 183 (4.1%) | 186 (17.1%) | 193 (27.4%) | < 0.001 | < 0.001 |
| Patiromer | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | – | – |
| Diuretics | 225 (5.1%) | 76 (7.0%) | 53 (7.5%) | < 0.05 | < 0.05 |
| Dialysis | 19 (0.4%) | 9 (0.8%) | 21 (3.0%) | 0.15 | < 0.001 |
| Potassium binding treatments at discharge, n (%) | |||||
| SPS at discharge | 15 (0.3%) | 21 (1.9%) | 37 (5.2%) | < 0.001 | < 0.001 |
| Patiromer at discharge | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | – | – |
| Direct admission to inpatient care, n (%) | |||||
| Admitted to inpatient care from ED | 252 (5.8%) | 91 (8.7%) | 80 (12.7%) | < 0.001 | < 0.001 |
ED emergency department, IV intravenous, N number, SD standard deviation, SPS sodium polystyrene sulfonate
aElectrocardiogram use was calculated among patients that had electrocardiogram data available (mild, n = 3808; moderate, n = 928; severe, n = 657); p values for categorical variables were calculated using chi-squared tests; p values for continuous variables were calculated using analysis of variance (ANOVA) tests