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对2014年1月至2015年8月期间前往急诊室的犬猫钾异常的严重程度及预后的回顾性评估:2441例病例。

Retrospective evaluation of the severity of and prognosis associated with potassium abnormalities in dogs and cats presenting to an emergency room (January 2014-August 2015): 2441 cases.

作者信息

Hoehne Sabrina N, Hopper Kate, Epstein Steven E

机构信息

William R. Pritchard Veterinary Medical Teaching Hospital (Hoehne) and the Department of Veterinary Surgical and Radiological Sciences (Hopper, Epstein), School of Veterinary Medicine, University of California, Davis, CA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2019 Nov;29(6):653-661. doi: 10.1111/vec.12889. Epub 2019 Sep 3.

Abstract

OBJECTIVE

To determine the severity, concurrent clinical signs, and disease processes associated with potassium abnormalities in dogs and cats presenting to a veterinary emergency department and associated mortality.

DESIGN

Retrospective and descriptive study over 20 months.

SETTING

University teaching hospital.

ANIMALS

1916 dog and 525 cat visits.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Medical records from patients with a potassium concentration measured within 24 hours of admission were identified. Hypokalemia and hyperkalemia were defined as a potassium concentration <3.5 mmol/L [3.5 mEq/L] and >5 mmol/L [5 mEq/L], respectively. Associated disease processes and pathophysiologic risk factors for potassium abnormalities were reviewed for moderate to severe potassium abnormalities (<3 mmol/L or ≥6 mmol/L) [<3 mEq/L or ≥6 mEq/L]. Mortality associated with normokalemia, mild, and moderate to severe dyskalemia were evaluated. Overall prevalence of abnormal potassium concentration was 27% in dogs and 40% in cats. Moderate to severe hypokalemia and hyperkalemia were present in 3% of dogs and 8% of cats, and 2% of dogs and 7% of cats, respectively. Moderate to severe hypokalemia was most commonly associated with gastrointestinal disease (48% of dogs and 44% of cats) while moderate to severe hyperkalemia was most commonly associated with urinary tract disease (60% of dogs and 97% of cats). Dogs with hypokalemia and dogs and cats with hyperkalemia (P < 0.001) had significantly greater mortality than those with normokalemia. Dogs with mild hypokalemia and mild hyperkalemia (P < 0.0001) had higher mortality than dogs with normokalemia, but this was not found in cats.

CONCLUSIONS

Dyskalemia was common in this population and was associated with greater mortality. Moderate to severe potassium abnormalities were uncommon in this population and occurred most frequently in animals with gastrointestinal and urinary tract disease.

摘要

目的

确定就诊于兽医急诊科的犬猫钾异常的严重程度、并发临床体征、相关疾病过程及死亡率。

设计

为期20个月的回顾性描述性研究。

地点

大学教学医院。

动物

1916例犬就诊病例和525例猫就诊病例。

干预措施

无。

测量指标及主要结果

确定入院24小时内测量过血钾浓度的患者的病历。低钾血症和高钾血症分别定义为血钾浓度<3.5 mmol/L [3.5 mEq/L]和>5 mmol/L [5 mEq/L]。对中重度钾异常(<3 mmol/L或≥6 mmol/L)[<3 mEq/L或≥6 mEq/L]相关的疾病过程和钾异常的病理生理风险因素进行回顾。评估与血钾正常、轻度及中重度血钾异常相关的死亡率。犬血钾浓度异常的总体患病率为27%,猫为40%。中重度低钾血症和高钾血症在犬中分别占3%和2%,在猫中分别占8%和7%。中重度低钾血症最常与胃肠道疾病相关(犬中占48%,猫中占44%),而中重度高钾血症最常与泌尿系统疾病相关(犬中占60%,猫中占97%)。低钾血症的犬以及高钾血症的犬和猫(P < 0.001)的死亡率显著高于血钾正常者。轻度低钾血症和轻度高钾血症的犬(P < 0.0001)的死亡率高于血钾正常的犬,但猫未发现此情况。

结论

血钾异常在该群体中很常见,且与更高的死亡率相关。中重度钾异常在该群体中不常见,最常发生于患有胃肠道和泌尿系统疾病的动物。

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