ArticleIntensive care medicine2012
Association between hyperkalemia at critical care initiation and mortality.
Article in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers.
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Who cites it
56 citing papers in PubMed.
- Emergency Potassium Normalization Treatment Including Sodium Zirconium Cyclosilicate: A Phase II, Randomized, Double-blind, Placebo-controlled Study (ENERGIZE).Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2020Trial
- Efficacy and safety of sodium zirconium cyclosilicate in patients with baseline serum potassium level ≥ 5.5 mmol/L: pooled analysis from two phase 3 trials.BMC nephrology · 2019Trial
- Association between Blood Potassium Level and Recovery of Postoperative Gastrointestinal Motility during Continuous Renal Replacement Therapy in Patient Undergoing Open Abdominal Surgery.BioMed research international · 2019Trial
- A phase 2 study on the treatment of hyperkalemia in patients with chronic kidney disease suggests that the selective potassium trap, ZS-9, is safe and efficient.Kidney international · 2015Trial
- Clinical impact of an EHR-integrated hyperkalemia management system: a real-world study of 10,934 episodes.Renal failure · 2026Article
- Serum potassium as a predictor of 28-day and in-hospital mortality in patients with sepsis: A U-shaped association.Chinese medical journal · 2026Article
- Association between serum potassium and 28-day mortality in elderly patients with sepsis: a multicenter cohort study.BMC geriatrics · 2025Article
- Dyskalaemia as a predictor of mortality in sepsis: a retrospective cohort study.BMC infectious diseases · 2025Article
- Linear association between serum potassium levels and 28-day mortality among ICU patients with diabetes and sepsis: a multicenter study.Frontiers in medicine · 2025Article
- The impact of tubular dysfunction and its relationship with acute kidney injury in children.Pediatric nephrology (Berlin, Germany) · 2024Article
- Machine learning models for early prediction of potassium lowering effectiveness and adverse events in patients with hyperkalemia.Scientific reports · 2024Article
- Effectiveness, safety, and treatment pattern of sodium zirconium cyclosilicate in Chinese patients with hyperkalemia: interim analysis from a multicenter, prospective, real-world study (Actualize Study).Frontiers in pharmacology · 2024Article
- Association of serum potassium levels with mortality in critically ill patients with sepsis during hospitalization.PloS one · 2024Article
- Variables associated to intensive care unit (ICU)-mortality among patients admitted to surgical intensive care unit in Ethiopia: a retrospective observational study.BMC anesthesiology · 2023Observational
- Prediction prolonged mechanical ventilation in trauma patients of the intensive care unit according to initial medical factors: a machine learning approach.Scientific reports · 2023Article
- Development and validation of a predictive model for the assessment of potassium-lowering treatment among hyperkalemia patients.World journal of emergency medicine · 2023Article
- A New Nomogram for Predicting 30-Day In-Hospital Mortality Rate of Acute Cholangitis Patients in the Intensive Care Unit.Emergency medicine international · 2023Article
- Association of serum potassium with decline in residual kidney function in incident hemodialysis patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022Article
- Motives, frequency, predictors and outcomes of MRA discontinuation in a real-world heart failure population.Open heart · 2022Article
- Clinical features, risk factors and a prediction model for in-hospital mortality among diabetic patients infected with COVID-19: data from a referral centre in Iran.Public health · 2022Article
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Authors and funding
4 authors.
Funding
Abstract
purposeTo investigate the association between potassium concentration at the initiation of critical care and all-cause mortality.
methodsWe performed a retrospective observational study on 39,705 patients, age ≥18 years, who received critical care between 1997 and 2007 in two tertiary care hospitals in Boston, Massachusetts. The exposure of interest was the highest potassium concentration on the day of critical care initiation and categorized a priori as 4.0-4.5, 4.5-5.0, 5.0-5.5, 5.5-6.0, 6.0-6.5, or ≥6.5 mEq/l. Logistic regression examined death by days 30, 90, and 365 post-critical care initiation, and in-hospital mortality. Adjusted odds ratios were estimated by multivariable logistic regression models.
resultsThe potassium concentration was a strong predictor of all-cause mortality 30 days following critical care initiation with a significant risk gradient across potassium groups following multivariable adjustment: K = 4.5-5.0 mEq/l OR 1.25 (95 % CI, 1.16-1.35; P < 0.0001); K = 5.0-5.5 mEq/l OR 1.42 (95 % CI, 1.29-1.56; P < 0.0001); K = 5.5-6.0 mEq/l OR 1.67 (95 % CI, 1.47-1.89; P < 0.0001); K = 6.0-6.5 mEq/l OR 1.63 (95 % CI, 1.36-1.95; P < 0.0001); K > 6.5 mEq/l OR 1.72 (95 % CI, 1.49-1.99; P < 0.0001); all relative to patients with K = 4.0-4.5 mEq/l. Similar significant associations post multivariable adjustments are seen with in-hospital mortality and death by days 90 and 365 post-critical care initiation. In patients whose hyperkalemia decreases ≥1 mEq/l in 48 h post-critical care initiation, the association between high potassium levels and mortality is no longer significant.
conclusionsOur study demonstrates that a patient's potassium level at critical care initiation is robustly associated with the risk of death even at moderate increases above normal.
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