Table 2.
Comparison of clinical characteristics among patients with mild, moderate, and severe hyperkalemia during the inpatient staya
| 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 = 15,083) | (N = 4,136) | (N = 2,574) | |||
| Death during Inpatient Stay, n (%) | |||||
| Patients who died | 1,852 (12.3%) | 643 (15.5%) | 502 (19.5%) | < 0.001 * | < 0.001 * |
| Length of Inpatient Stay, mean (SD) | |||||
| Total days in inpatient care | 9.1 (7.5) | 8.5 (7.1) | 7.5 (6.6) | < 0.001 * | < 0.001 * |
| Days from admission to first high potassium lab | 2.6 (4.3) | 1.9 (3.8) | 1.2 (3.3) | < 0.001 * | < 0.001 * |
| Days from first high potassium lab to discharge | 6.5 (6.0) | 6.6 (5.9) | 6.3 (5.7) | 0.20 | 0.09 |
| Potassium Lab Values during Inpatient Stay | |||||
| Number of potassium lab values, mean (SD) | 9.1 (11.3) | 10.1 (10.9) | 10.9 (11.4) | < 0.001 * | < 0.001 * |
| Patients with ≥2 potassium lab values, n (%) | 13,680 (90.7%) | 3,965 (95.9%) | 2,491 (96.8%) | < 0.001 * | < 0.001 * |
| Among patients with ≥2 lab values | |||||
| First potassium lab value, mean (SD) | 5.2 (0.1) | 5.8 (0.1) | 6.7 (0.7) | < 0.001 * | < 0.001 * |
| Last potassium lab value, mean (SD) | 4.3 (0.7) | 4.3 (0.7) | 4.4 (0.9) | 0.85 | < 0.001 * |
| Potassium lab value returned to ≤5.0 mEq/L during the stay, n (%) | 12,000 (87.7%) | 3,441 (86.8%) | 2,041 (81.9%) | < 0.001 * | < 0.001 * |
| Monitoring during Inpatient Stay, n (%) | |||||
| Electrocardiogramb | 6,497 (51.9%) | 2,272 (67.9%) | 1,773 (82.6%) | < 0.001 * | < 0.001 * |
| Hyperkalemia treatment during Inpatient Stay, n (%) | |||||
| Any temporizing agent | 4,352 (28.9%) | 1,904 (46.0%) | 1,880 (73.0%) | < 0.001 * | < 0.001 * |
| Albuterol | 947 (6.3%) | 523 (12.6%) | 810 (31.5%) | < 0.001 * | < 0.001 * |
| Calcium | 2,487 (16.5%) | 1,231 (29.8%) | 1,452 (56.4%) | < 0.001 * | < 0.001 * |
| Insulin with glucose | 1,220 (8.1%) | 839 (20.3%) | 1,251 (48.6%) | < 0.001 * | < 0.001 * |
| Sodium bicarbonate | 2,173 (14.4%) | 884 (21.4%) | 975 (37.9%) | < 0.001 * | < 0.001 * |
| SPS | 1,759 (11.7%) | 1,151 (27.8%) | 1,167 (45.3%) | < 0.001 * | < 0.001 * |
| Patiromer | 2 (0.0%) | 2 (0.0%) | 3 (0.1%) | 0.20 | < 0.05 * |
| Diuretics | 4,930 (32.7%) | 1,536 (37.1%) | 890 (34.6%) | < 0.001 * | 0.06 |
| Dialysis | 1,709 (11.3%) | 614 (14.8%) | 578 (22.5%) | < 0.001 * | < 0.001 * |
| Hyperkalemia Treatments at Discharge, n (%) | |||||
| SPS at discharge | 10 (0.1%) | 6 (0.1%) | 10 (0.4%) | 0.21 | < 0.001 * |
| Patiromer at discharge | 0 (0.0%) | 1 (0.0%) | 2 (0.1%) | 0.22 | < 0.05 * |
| Diuretics at discharge | 1,289 (8.5%) | 376 (9.1%) | 200 (7.8%) | 0.28 | 0.20 |
| Other treatments, n (%) | |||||
| RAASi during inpatient stay | 1,702 (11.3%) | 488 (11.8%) | 238 (9.2%) | 0.37 | <0.01 * |
| RAASi at discharge | 860 (5.7%) | 256 (6.2%) | 126 (4.9%) | 0.25 | 0.11 |
*
p-values <0.05 were considered statistically significant.
a
Variables analyzed between the first potassium lab >5.0mEq/L during stay and the discharge date.
b
ECG use was calculated among patients with ECG data available (mild hyperkalemia, n = 12,522; moderate hyperkalemia, n = 3,345; severe hyperkalemia, n = 2,147); p-values for categorical variables were calculated using chi-squared tests; p-values for continuous variables were calculated using analysis of variance tests.
ECG, electrocardiogram; n, number; SD, standard deviation; RAASi, renin-angiotensin-aldosterone system inhibitor; SPS, sodium polystyrene sulfonate