ArticleCritical care (London, England)2015
The relationship between serum potassium, potassium variability and in-hospital mortality in critically ill patients and a before-after analysis on the impact of computer-assisted potassium control.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed.
- Association of serum potassium time in target range with cardiovascular outcomes in patients with HFpEF.Open heart · 2025Trial
- Electrolyte and mineral disturbances in septic acute kidney injury patients undergoing continuous renal replacement therapy.Medicine · 2016Trial
- Dynamic Variability of Sodium and Potassium Predicts Mortality in Critically Ill Patients With Ischemic Stroke: Evidence From Two Critical Care Cohorts.Brain and behavior · 2026Article
- Evaluating the Severity of Reported Potassium-Related Errors and Developing Safeguards to Improve Potassium Safety in Critical Care-a Modified Expert Panel Study.Journal of patient safety · 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
- Impact of postoperative serum potassium levels and variability on 1-year mortality rate in coronary artery bypass grafting patients: a retrospective cohort study.Journal of cardiothoracic surgery · 2026Article
- From Biomarkers to Biosensors: Transforming Comorbidity Management in Dialysis Care.Sensors (Basel, Switzerland) · 2026Review
- Supplementation of calcium, magnesium, phosphate, and potassium in critically ill patients: A multicenter cohort study.PloS one · 2026Article
- Association between serum potassium and 28-day mortality in elderly patients with sepsis: a multicenter cohort study.BMC geriatrics · 2025Article
- Deep Learning-Based 30-Day Mortality Prediction in Critically Ill Bone and Bone Marrow Metastasis Patients: A Multicenter Retrospective Cohort Study.Current oncology (Toronto, Ont.) · 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
- Associations between serum potassium variability and mortality in patients undergoing maintenance hemodialysis: a retrospective study.Scientific reports · 2024Article
- Association between serum glucose potassium ratio and mortality in critically ill patients with intracerebral hemorrhage.Scientific reports · 2024Article
- Metabolic alkalosis: a new red flag in status epilepticus.Journal of neurology · 2024Observational
- Article
- The effect of pediatric acute potassium chloride correction infusions on the serum potassium concentration.Critical care science · 2024Article
- Association of serum potassium levels with mortality in critically ill patients with sepsis during hospitalization.PloS one · 2024Article
- Risk factors for new-onset atrial fibrillation during critical illness: A Delphi study.Journal of the Intensive Care Society · 2022Article
- First 24-Hour Potassium Concentration and Variability and Association with Mortality in Patients Requiring Continuous Renal Replacement Therapy in Intensive Care Units: A Hospital-Based Retrospective Cohort Study.Journal of clinical medicine · 2022Article
- Serum potassium variability as a predictor of clinical outcomes in patients with cardiorenal disease or diabetes: a retrospective UK database study.Clinical kidney journal · 2022Article
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7 authors.
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Abstract
introductionThe relationship between potassium regulation and outcome is not known. Our first aim in the present study was to determine the relationship between potassium level and variability in (ICU) stay and outcome. The second aim was to evaluate the impact of a computer-assisted potassium regulation protocol.
methodsWe performed a retrospective before-after study including all patients >15 years of age admitted for more than 24 hours to the ICU of our university teaching hospital between 2002 and 2011. Potassium control was fully integrated with computerized glucose control (glucose and potassium regulation program for intensive care patients (GRIP-II)). The potassium metrics that we determined included mean potassium, potassium variability (defined as the standard deviation of all potassium levels) and percentage of ICU time below and above the reference range (3.5 through 5.0 mmol/L). These metrics were determined for the first ICU day (early phase) and the subsequent ICU days (late phase; that is, day 2 to day 7). We also compared potassium metrics and in-hospital mortality before and after GRIP-II was implemented in 2006.
resultsOf all 22,347 ICU admissions, 10,451 (47%) patients were included. A total of 206,987 potassium measurements were performed in these patients. Glucose was regulated by GRIP-II in 4,664 (45%) patients. The overall in-hospital mortality was 22%. There was a U-shaped relationship between the potassium level and in-hospital mortality (P <0.001). Moreover, potassium variability was independently associated with outcome. After implementation of GRIP-II, in the late phase the time below 3.5 mmol/L decreased from 9.2% to 3.9% and the time above 5.0 mmol/L decreased from 6.1% to 5.2%, and potassium variability decreased from 0.31 to 0.26 mmol/L (all P <0.001). The overall decrease in in-hospital mortality from 23.3% before introduction of GRIP-II to 19.9% afterward (P <0.001) was not related to a specific potassium subgroup.
conclusionsHypokalemia, hyperkalemia and potassium variability were independently associated with increased mortality. Computerized potassium control clearly resulted in improved potassium metrics.
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