Choi Dong Sun, Shin Sang Do, Ro Young Sun, Lee Kyung Won
Department of Emergency Medicine, Seoul National University Hospital, South Korea.
Biomedical Research Institute, Seoul National University Hospital, South Korea.
Adv Clin Exp Med. 2020 Jun;29(6):727-734. doi: 10.17219/acem/122178.
Sudden cardiac arrest is a major cause of death worldwide. Serum potassium level is an initial laboratory test that serves as part of an electrolyte panel easily obtainable by most emergency departments (EDs).
To evaluate the relationship between serum potassium level and the survival outcome for out-of-hospital cardiac arrest (OHCA) patients.
We used the Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiological Surveillance (CAPTURES) database, which made up the OHCA cohort of 27 EDs in Korea from January to December 2014. The inclusion criteria were all OHCA patients in the cohort who had received cardiopulmonary resuscitation (CPR) in the hospital. The patients were excluded if they were transferred from another hospital, had a pre-hospital return of spontaneous circulation (ROSC), or if the potassium level and clinical outcome data were missing or not captured. The main parameter was serum potassium level on ED arrival. According to the serum potassium level, the patients were divided into a hypokalemia group (K+ < 3.5 mEq/L), a normokalemia group (K+ = 3.5-5.4 mEq/L) and a hyperkalemia group (K+ ≥ 5.5 mEq/L). The primary outcome was neurologically favorable survival discharge.
Among the 1,616 patients in the CAPTURES cohort, 913 patients were included in the analysis, of whom 46 patients (5.9%) were assigned to the hypokalemia group, 370 patients (40.5%) were assigned to the normokalemia group and 497 patients (54.4%) were assigned to the hyperkalemia group. The hypokalemia group has a significantly higher percentage of good neurological outcomes (26.1%). There was a significant positive correlation with neurologically favorable survival (odds ratio (OR) = 4.45; 95% confidence interval (95% CI) = 1.67-11.91) and a significant positive correlation with survival discharge (OR = 2.25; 95% CI = 1.05-4.82).
In OHCA patients, serum potassium level measured in the hospital showed a significant association with survival outcome. Hypokalemia had a significant association with good neurological outcome and survival discharge.
心脏骤停是全球主要的死亡原因。血清钾水平是一项初始实验室检查，是大多数急诊科（ED）都能轻松获取的电解质检查项目的一部分。
评估血清钾水平与院外心脏骤停（OHCA）患者生存结局之间的关系。
我们使用了具有独特登记和流行病学监测的心脏骤停追踪试验（CAPTURES）数据库，该数据库构成了2014年1月至12月韩国27个急诊科的OHCA队列。纳入标准为该队列中所有在医院接受过心肺复苏（CPR）的OHCA患者。如果患者是从另一家医院转来的、院外恢复自主循环（ROSC），或者钾水平和临床结局数据缺失或未获取，则将其排除。主要参数是急诊科就诊时的血清钾水平。根据血清钾水平，患者被分为低钾血症组（K+<3.5 mEq/L）、正常钾血症组（K+ = 3.5 - 5.4 mEq/L）和高钾血症组（K+≥5.5 mEq/L）。主要结局是神经功能良好的存活出院。
在CAPTURES队列的1616例患者中，913例患者纳入分析，其中46例（5.9%）被分配到低钾血症组，370例（40.5%）被分配到正常钾血症组，497例（54.4%）被分配到高钾血症组。低钾血症组神经功能良好结局的比例显著更高（26.1%）。与神经功能良好的存活存在显著正相关（比值比（OR）= 4.4
