The Importance of Potassium Ion Disturbances in Emergency Care

OBJECTIVES: The presence of potassium disorders in the emergency departments is remarkable and can lead to significant morbidity and mortality. Our aim was to describe the occurrence, treatment, the outcome and the influencing factors of hyperkalaemia and hypokalaemia. A cross-sectional retrospective study was performed anonymously.

METHODS: The sample consisted of patients diagnosed with hypo- (n₁=130) or hyperkalemia (n₂=70) at the Emergency Department of the Géza Hetényi Hospital of the Jász-Nagykun-Szolnok County Hospital between September and December 2021 following a non-random sampling technique (n=200). The obtained data was evaluated by descriptive and mathematical statistical calculations (chi² test, two-sample T-test, ANOVA and correlation analysis) using SPSS software (p<0.05).

RESULTS: Predisposing factors for hypokalaemia included female gender (p<0.001) and hypertension (p=0.04). 60% of patients with moderate hypokalaemia were diagnosed with hypertension (p=0.003). Higher blood glucose values (p<0.001), diabetes mellitus (p<0.001) and chronic kidney disease (p<0.001) were associated with hyperkalaemic conditions. The more severe the potassium abnormality, the more likely it was to have diagnostic ECG abnormalities, which occurred in 48.6% of patients with hyperkalaemia (p<0.001). Regarding presentation complaints, the level of SeK was the highest in the case of dyspnoea (p <0.001). The majority of patients requiring life-saving procedures had severe hypokalaemia (p<0.001). Hyperkalaemia and hypokalaemia were often associated with hospitalization and less frequently with death.

CONCLUSIONS: The development of unified guidelines for the treatment of dyskalemic conditions would certainly be helpful, which could greatly increase patient safety and facilitate the decision-making process of medical providers in critical situations.