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Effect of cardiovascular comorbidities on the mortality risk associated with serum potassium

Session Poster session 1 Saturday 08:30 -17:30

Speaker Bertram Pitt

Congress : Heart Failure 2015

  • Topic : e-cardiology / digital health, public health, health economics, research methodology
  • Sub-topic : Research Methodology
  • Session type : Poster Session
  • FP Number : P458

Authors : B Pitt (Ann Arbor,US), AJ Collins (Minneapolis,US), NL Reaven (La Cañada Flintridge,US), SA Funk (La Cañada Flintridge,US), GL Bakris (Chicago,US), DA Bushinsky (Rochester,US)

B Pitt1 , AJ Collins2 , NL Reaven3 , SA Funk3 , GL Bakris4 , DA Bushinsky5 , 1University of Michigan School of Medicine - Ann Arbor - United States of America , 2University of Minnesota - Minneapolis - United States of America , 3Strategic Health Resources - La Cañada Flintridge - United States of America , 4University of Chicago Medicine - Chicago - United States of America , 5University of Rochester - Rochester - United States of America ,

European Journal of Heart Failure Abstracts Supplement ( 2015 ) 17 ( Supplement 1 ), 107

Purpose: Hypo- and hyperkalemia are associated with an increased mortality risk. Serum potassium (K+) levels associated with these risks and relationships to comorbidity, however, are not well defined. We evaluated the odds of death in patients with and without comorbid conditions, stratified by K+ level.

Methods: De-identified medical records (2007-2012) from a large US population aged ≥5 years with 2 or more K+ readings were evaluated. Patients aged 45-64 years with comorbidities of CKD stages 3-5, heart failure, diabetes, hypertension, and cardiovascular disease (n = 231,070) were identified by ICD-9 codes and biochemical data, excluding those with acute kidney injury or end stage renal disease, and compared with controls without these conditions (n = 146,645). A separate analysis of patients aged ≥65 years was conducted. Index K+ value was defined as the last reported value prior to a pre-determined cut-off date. Mortality was evaluated through hospital discharge records and Social Security registry information.

Results: Patients with cardiorenal comorbidities aged 45-64 years and index K+ levels <4.1 mEq/L and >4.6 mEq/L had a significant increase in mortality (Figure). This finding was also observed in patients aged ≥65 years. The general pattern remained after adjustments for demographic characteristics (sex, race) and comorbidities associated with the propensity to develop hypo- and hyperkalemia.

Conclusions: Our results confirm that patients with hypo- or hyperkalemia are at greater risk for mortality than those with normal K+, and that mortality risk is significantly higher in patients with cardiorenal comorbidities and is independent of demographic characteristics. The increased mortality in patients with comorbidities occurs even at K+ levels within the usual normal laboratory range.

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