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老年患者社区获得性低钾血症:相关因素及临床结局

Community-acquired hypokalemia in elderly patients: related factors and clinical outcomes.

作者信息

Bardak S, Turgutalp K, Koyuncu M B, Harı H, Helvacı I, Ovla D, Horoz M, Demir S, Kıykım A

机构信息

Division of Nephrology, Department of Internal Medicine, School of Medicine, Mersin University, 33079, Mersin, Turkey.

Department of Business Information and Biostatistic Management, Silifke School of Applied Technology and Management, Mersin University, Silifke/Mersin, Turkey.

出版信息

Int Urol Nephrol. 2017 Mar;49(3):483-489. doi: 10.1007/s11255-016-1489-3. Epub 2016 Dec 29.

Abstract

PURPOSE

Electrolyte imbalance is a common problem affecting the elderly. Increased number of comorbidities and frequent use of drugs may contribute to increased risk of hypokalemia in the elderly. This study was performed to investigate the prevalence of community-acquired hypokalemia (CAH), risk factors for its development, related factors with hypokalemia, and morbidities and all-cause mortality rates (MR) of CAH in the elderly patients.

METHODS

Total of 36,361 patients aged above 65 years were screened retrospectively. Group 1 consisted of 269 elderly patients with potassium level ≤3.5 mmol/L, and group 2 (control group) consisted of 182 subjects with potassium level between 3.6 and 5.5 mmol/L. Etiologic factors of CAH, presence of comorbidities, duration of hospital stay, hospital cost, and clinical outcomes were recorded.

RESULTS

Prevalence of hypokalemia was found 3.24% in patients aged above 65 years. Duration of hospital stay, presence of ≥2 comorbid diseases, hospital cost, and MR were significantly higher in group 1 compared to group 2 (p < 0.001 for all). Loop diuretics, hydrochlorothiazides, beta agonists, inadequate oral intake, and female gender were all independent risk factors for CAH in elderly patients. Patients with ≥2 comorbid diseases were found to have greater risk of hypokalemia than the patients with <2 comorbidities.

CONCLUSIONS

Length of hospital stay, hospital cost, and MR were higher in elderly with CAH. Female gender, hydrochlorothiazides, loop diuretics, and ≥2 comorbid diseases are the leading risk factors associated with CAH in elderly.

摘要

目的

电解质失衡是影响老年人的常见问题。合并症数量增加和药物的频繁使用可能导致老年人低钾血症风险增加。本研究旨在调查社区获得性低钾血症(CAH)的患病率、其发生的危险因素、与低钾血症相关的因素以及老年患者CAH的发病率和全因死亡率(MR)。

方法

回顾性筛查了总共36361名65岁以上的患者。第1组由269名血钾水平≤3.5 mmol/L的老年患者组成,第2组(对照组)由182名血钾水平在3.6至5.5 mmol/L之间的受试者组成。记录CAH的病因、合并症的存在情况、住院时间、住院费用和临床结局。

结果

65岁以上患者中低钾血症的患病率为3.24%。与第2组相比,第1组的住院时间、≥2种合并疾病的存在、住院费用和MR均显著更高(所有p<0.001)。袢利尿剂、氢氯噻嗪、β受体激动剂、口服摄入不足和女性性别都是老年患者CAH的独立危险因素。发现患有≥2种合并疾病的患者比患有<2种合并疾病的患者发生低钾血症的风险更高。

结论

CAH老年患者的住院时间、住院费用和MR更高。女性性别、氢氯噻嗪、袢利尿剂和≥2种合并疾病是老年患者CAH的主要相关危险因素。

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